口咽及扁桃体原发性梅毒六例  

Clinicopathologic features of syphilis in oropharynx:report of 6 cases and literature review

作　　者：侯义亮 王新国 王振征[3] HOU Yiliang WANG Xinguo WANG Zhenzheng(Department of Pathology, The Center Hospital of Feicheng Mineral Group Company, Feicheng 271608, China Jinan Kingmed Center for Clinacal Lab, Jinan 250101, China Department of Pathology, 456th Hospital of PLA, Jinan 250031, China)

机构地区：[1]山东省肥城矿业中心医院病理科,肥城271608 [2]济南金域医学检验中心,济南250101 [3]解放军第456医院病理科,济南250031

出　　处：《中国麻风皮肤病杂志》2016年第12期730-732,共3页China Journal of Leprosy and Skin Diseases

摘　　要：目的:观察口咽部梅毒组织病理学、血清学以及梅毒螺旋体免疫组化染色特点。方法:运用鼻咽镜、组织学及免疫组化技术对6例口咽部梅毒进行光镜观察及免疫组化标记,并结合相关文献对其临床表现、组织形态和免疫组化特点等进行综合分析。结果:6例患者男4例,女2例,平均年龄28.3岁。病损以黏膜红斑、白斑及糜烂为主,也可见隆起的斑块伴浅溃疡。血清学检查均表现为RPR>1∶8(+)、TPPA(+)。组织学上在鳞状上皮下黏膜固有层内可见密集的浆细胞、组织细胞及淋巴细胞等炎症细胞浸润,构成肉芽肿样病变,并可见血管炎。免疫组化染色可见组织内散在分布的梅毒螺旋体。结论:口咽及扁桃体原发性梅毒的组织学及病原学检查具有特异性,以口咽部黏膜红斑、白斑、糜烂或溃疡为首发症状的患者应引起耳鼻咽喉科医生重视,应想到梅毒的可能性并做相关病理学和病原学检查。Objective：To investigate the features of the histopathologyand serologyof syphilis in oropharynx and the immunohistochemical staining characteristics of treponema pallidum. Methods：Six syphilis patients in oropharynx were analysed by means of epipharyngoscope, histopathology, immuno-histochemistry and serology. Furthermore, the features of clinical presentation, histology, and immunohistochemistry of those patients were generally analysed combined with the related literatures. Results： The average age of ten rolled patients was 28.3 years. Erythema, leukoplakia, and erosion of mucous membrane were the main presentation, and the protruding plaque was also noted. The serologic examination showed RPR〉1∶8（＋） , TPPA（＋） . Histologic examination demonstrated the infiltration of massive plasma cells, histocytes, and lymphocytes in the lamina propria of mucous membrane underlying the squamous epithelium layer, constituting the granulomatous pattern. The vasculitis was also present. The scattered Micropironema pallidum was detected by immunostaining. Conclusion：The features of the histopathology and serology of syphilis in oropharynx mucosa had its specific characteristics, and the primary lesions of erythema, leukoplakia and erosion or ulcers in oropharynx should be attracted attention by the otolaryngology doctors, and the potential diagnosis of syphilis should be thought and confirmed by pathological and pathogenic examination.

关 键 词：口咽部 梅毒 临床病理特征 免疫组化 

分 类 号：R759.1[医药卫生—皮肤病学与性病学]