鼻硬结病的临床病理分析  

Clinicopathologic analysis of rhinoscleroma

作　　者：张盛忠[1] 卢志达[1] 倪鑫[2] 张勇[1] 洪明理[3] 

机构地区：[1]北京首都医科大学附属北京同仁医院病理科,100730 [2]北京首都医科大学附属北京同仁医院耳鼻咽喉科 [3]北京友谊医院电镜室

出　　处：《中华耳鼻咽喉科杂志》2001年第1期42-43,T006,共3页Chinese Journal of Otorhinolaryngology

摘　　要：目的　观察鼻硬结病的组织病理学和临床特点 ,探讨鼻硬结杆菌对宿主造成组织损伤的机理。方法　以 2 4例鼻硬结病患者的组织标本为研究对象 ,用HE及组织化学W S(Warthin Starry)染色 ,其中 11例组织分别用CD4 3(T淋巴细胞 )、CD2 0 (B淋巴细胞 )、CD68(巨噬细胞 )、溶菌酶抗体免疫组化ABC法染色 ,2例进行透射电镜观察。结果　肉芽肿期 15例 ,纤维瘢痕期 9例。W S染色和电镜观察均在Mikulicz细胞内检测出大量鼻硬结杆菌 ,细胞外偶见。电镜下Mikulicz细胞内出现大量吞噬体 ,将细胞器挤到一侧 ,粗面内质网及溶酶体很少。在病变组织内T淋巴细胞很少 ,Mikulicz细胞的溶菌酶抗体表达较弱。结论　鼻硬结病患者显示细胞免疫功能障碍的特点 。Objective To investigate the clinicopathologic characteristics and reason of tissue injury caused by klebsiella rhinoscleromatis (KR) infection. Methods Twenty four cases of rhinoscleromas in the nasal and pharyngeal region in this hospital from March 1983 to March 1998 were studied retrospectively. Warthin Starry(W S) stain was used in all cases and CD 43 、CD 20 、CD 68 、Lysozyme mark were observed in eleven specimens by ABC immunochemical method. Two cases were studied further with transmission electron microscopy. Results A great number of KR were found in Mikulicz cells and were confirmed further in the phagosomes in cytoplasm of Mikulicz cells, where a small number of endoplasmic reticulums and lysozymes was squeezed to the side of cells. A few of T lyphocytes was found within the granuloma. Conclusion Cellular immunity function of the patient with rhinoscleroma was depressed and the response to immunization of host which regards to KR was the major cause of tissue injury.

关 键 词：鼻硬结病 免疫组织化学 电子显微镜 检查 

分 类 号：R765[医药卫生—耳鼻咽喉科]