Shibuya K, Coulson W F, Wollman J S, Wakayama M, Ando T, Oharaseki T, Takahashi K, Naoe S
Department of Pathology, Toho University Ohashi Hospital, Tokyo, Japan.
Int J Infect Dis. 2001;5(2):78-85. doi: 10.1016/s1201-9712(01)90030-x.
To gain insight into the histopathologic characteristics of fungal infection in acquired immunodeficiency syndrome (AIDS).
A review was conducted of the histopathology for 162 patients with evident fungal infection.
The microscopic appearance of esophageal candidiasis that was common in patients with single organ involvement revealed necrotic debris containing proliferating hyphae at the site of mucosal erosions without fungal invasion of underlying tissue. The incidence of oral and esophageal candidiasis was followed by that of pulmonary aspergillosis and Candida infection. Eighteen patients had generalized cryptococcosis, representing the commonest generalized fungal disease. The essential histologic features of the disease consisted of yeast cell proliferation with a histiocytic response, but only minor lymphocytic and neutrophilic components. This was different from the manifestations of both Candida and Aspergillus infections. The two histologic patterns recognized in the pulmonary cryptococcal lesions could be graded with respect to the degree and type of inflammatory reaction. The milder one consisted of small scattered foci of intra-alveolar cryptococcal proliferation with a histiocytic response. Another pattern involved massive cryptococcal infection, which might be simply more extensive than that in the former. Capillary involvement of alveolar septa was an important common finding in all 18 patients.
深入了解获得性免疫缺陷综合征（AIDS）患者真菌感染的组织病理学特征。
对162例有明显真菌感染的患者的组织病理学进行回顾性研究。
在单器官受累患者中常见的食管念珠菌病的显微镜下表现为黏膜糜烂部位有含增殖菌丝的坏死碎屑，真菌未侵犯下层组织。口腔和食管念珠菌病的发病率仅次于肺曲霉病和念珠菌感染。18例患者发生播散性隐球菌病，是最常见的播散性真菌病。该病的基本组织学特征包括酵母细胞增殖伴组织细胞反应，但淋巴细胞和中性粒细胞成分较少。这与念珠菌和曲霉感染的表现不同。肺隐球菌病变中识别出的两种组织学模式可根据炎症反应的程度和类型进行分级。较轻的一种模式由肺泡内散在的小灶性隐球菌增殖伴组织细胞反应组成。另一种模式涉及大量隐球菌感染，可能只是比前者更广泛。肺泡间隔的毛细血管受累是所有18例患者的一个重要共同发现。
