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目的观察头颈部霉菌病的临床病理特点,探讨发病机制。方法对255例经病理组织学证实的头颈部霉菌病患者的临床和组织病理资料进行回顾性分析。以改良Warthin-Starry(W-S)、PAS染色显示真菌的形态特征。对2例非侵袭性和1例侵袭性霉菌病黏膜行透射电镜观察。结果显微镜下检出非侵袭性霉菌病234例,149例为霉菌球,其中77.65%霉菌团块中菌丝有钙化;15例霉菌菌团下黏膜有糜烂;34例为变应性霉菌性鼻窦炎,黏膜内见大量嗜酸性粒细胞浸润,黏膜表面分泌物中可见大量嗜酸性粒细胞渗出及Charcot-Leiden结晶,并可见少数曲霉菌菌丝及孢子;其余36例霉菌在咽部、梨状窝、喉、硬腭、乳突黏膜表面炎性渗出物及外耳道角化物中被发现。侵袭性霉菌病21例,分别侵袭鼻腔、单侧及多组副鼻窦、咽部、乳突腔及颌下淋巴结,其中9例伴同侧眼眶受累。结论不同类型的霉菌病病理形态不同,其发生、发展与机体的免疫状态有关。
Objective To observe the clinicopathological features of head and neck mycosis and to explore the pathogenesis. Methods The clinical and histopathological data of 255 patients with pathologically confirmed head and neck mycosis were retrospectively analyzed. The morphological characteristics of fungi were revealed by PAS staining with modified Warthin-Starry (W-S). Two cases of non-invasive and one case of invasive mycosis mucosa underwent transmission electron microscopy. Results 234 cases of non-invasive mycosis were detected under the microscope, 149 cases were mycosphere, of which 77.65% were mycotic calcification in mycotic clumps; 15 cases were erosion of mycobacteria; 34 cases were allergic mycotic sinus Inflammation, a large number of mucosal eosinophilic infiltration, a large number of eosinophilic exudate mucosal surface effusion and Charcot-Leiden crystallization, and a small number of Aspergillus mycelium and spores can be seen; the remaining 36 cases of mold in the pharynx, pear Cervical fossa, throat, hard palate, mastoid mucosal inflammatory exudate and external auditory meatal lesions were found. Invasive mycosis in 21 cases, respectively, nasal invasion, unilateral and multiple paranasal sinus, pharynx, mastoid cavity and submandibular lymph nodes, including 9 cases with ipsilateral orbital involvement. Conclusion Different types of mycosis pathological morphology is different, its occurrence and development and the body’s immune status.