Dias E P, Spyrides K S, Silva Júnior A S, Rocha M L, da Fonseca E C
Departamento de Patologia da Universidade Federal Fluminense.
Pesqui Odontol Bras. 2001 Apr-Jun;15(2):104-11. doi: 10.1590/s1517-74912001000200005.
Oral hairy leukoplakia (OHL) is one of the most common oral manifestations of AIDS, with diagnostic and prognostic value. OHL is associated to the Epstein-Barr virus and presents clinical and histological defined characteristics. There have already been reports about a subclinical stage of OHL, although they lacked histopathologic characterization. The present study had the aim to describe the histopathological characteristics of subclinical hairy leukoplakia, as well as to carry out a comparative analysis between clinical and subclinical OHL. For that, 11 cases were analyzed--5 biopsies from patients who presented with the lesion and 6 samples from the borders of tongues obtained in necropsies. The histopathological findings in subclinical OHL were: absence of parakeratosis and papillomatosis, mild acanthosis, ballooning cells and nuclear alterations. In situ hybridization and immunostaining were positive for EBV in the nuclear alterations identified in the histopathological analysis. Based on the identification of EBV in the nuclear alterations, it was possible to conclude that subclinical OHL, similarly to the clinical lesion, presents histopathological features that are specific and sufficient to establish the definitive diagnosis, regardless of the identification of the virus.
口腔毛状白斑（OHL）是艾滋病最常见的口腔表现之一，具有诊断和预后价值。OHL与爱泼斯坦-巴尔病毒有关，具有明确的临床和组织学特征。虽然已有关于OHL亚临床阶段的报道，但这些报道缺乏组织病理学特征描述。本研究旨在描述亚临床毛状白斑的组织病理学特征，并对临床和亚临床OHL进行比较分析。为此，分析了11例病例——5例来自有病变患者的活检组织和6例尸检时取自舌边缘的样本。亚临床OHL的组织病理学表现为：无角化不全和乳头瘤样增生，轻度棘层肥厚，气球样细胞和核改变。在组织病理学分析确定的核改变中，原位杂交和免疫染色检测EBV呈阳性。基于在核改变中鉴定出EBV，可以得出结论，亚临床OHL与临床病变相似，具有足以确立明确诊断的特异性组织病理学特征，无论病毒是否被鉴定出来。
