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혈관형치핵과 점막형치핵 간의 조직학적 차이점

Histological Differences between Vascular and Mucosal Hemorrhoids

대한대장항문학회지 2009년 25권 6호 p.372 ~ 379
임청호 ( Lim Cheong-Ho ) - 양병원 대장항문외과

신현근 ( Shin Hyeon-Keun ) - 양병원 대장항문과
이영찬 ( Lee Young-Chan ) - 양병원 대장항문외과
최동현 ( Choi Dong-Hyun ) - 양병원 대장항문외과
황재관 ( Hwang Jae-Kwan ) - 양병원 대장항문외과
장한정 ( Chang Han-Jeong ) - 양병원 대장항문외과
고용택 ( Ko Yong-Taek ) - 양병원 대장항문외과
정승규 ( Jung Seung-Kyu ) - 양병원 대장항문과
양형규 ( Yang Hyung-Kyu ) - 양병원 대장항문과
이헌경 ( Lee Hun-Kyung ) - 이화검사센타 병리과


Purpose: The aim of this study is to compare and analyze the histological differences between vascular and mucosal hemorrhoids, two structurally different types of hemorrhoids.

Methods: Internal hemorrhoidal tissue samples were fixed in 10% Formalin solution, and coronal sections included 10-mm proximal and 5-mm distal of the dentate line. Routine Masson-Trichrome and H&E were performed to evaluate the thickness of the mucosa and changes in the structure and the densities of submucosal vessels, connective tissue, and muscle.

Results: Compared with the corresponding tissues of mucosal hemorrhoids, the submucosal connective tissue and perivascular connective tissue of vascular hemorrhoids showed a loosened density, severe fragmentation, and an irregular arrangement. The submucosal vascular dilatation was more frequent and more severe in vascular hemorrhoids, but the number of vessels between both types of hemorrhoids did not show much difference. Hypertrophy and regular arrangement of the submucosal muscles were observed more frequently in the mucosal than in the vascular hemorrhoids.

Conclusion: Compared to mucosal hemorrhoids, vascular hemorrhoids showed augmented damage in submucosal connective tissue and intense dilatation of vessels with a thinner mucosa. On the other hand, compared to vascular hemorrhoids, mucosal hemorrhoids showed hypertrophy of submucosal muscle and relatively minor alterations in vessels with a thicker mucosa. These histological differences may provide the basis for different etiologies between vascular and mucosal hemorrhoids.


치핵;혈관형치핵;점막형치핵;조직학적 차이점
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