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[口咽部早期梅毒的病因学及临床病理学研究]

[An etiological and clinicopathological study of early syphilis in oropharynx].

作者信息

Zhang Shengzhong, Liu Honggang, Wang Yuxin, Li Qiuzhen, He Chunyan

机构信息

Department of Pathology, Beijing Tong Ren Hospital, Capital University of Medical Science, Beijing 100730, China.

出版信息

Zhonghua Er Bi Yan Hou Ke Za Zhi. 2002 Dec;37(6):450-3.

Abstract

OBJECTIVE

To investigate the characteristics of the early stage treponema pallidum infected tissue in ear, nose, oropharynx and larynx and to raise relevance ratio of syphilis in nose and oropharynx and enhance doctor's self-protection awareness.

METHODS

The histopathologic characteristics were studied by using HE staining, Warthin-Starry (W-S) staining was adopted to examine the treponema pallidum(TP) in lesion issue and its exudates smear for 12 cases biopsy tissues of suspicious syphilis. The diagnosis was confirmed by venereal disease research laboratory (VDRL), rapid plasma reagin circle test(RPR), treponema pallidum hemagglutination test(TPHA) and fluorescent treponemal antibody-absorption test (FTA-ABS). Treat with curing syphilis methods which published by nation.

RESULTS

In the 12 cases mucous membrane specimen, the squamous epithelium proliferated, neutrophilic granulocyte infiltrated, within inherent membrane generous plasmacyte and lymphocyte infiltrated. W-S staining: plenty of treponema pallidum were found inside mucous membrane epithelium and exudate smear. Serology examination: 11 cases VDRL(++++), 7 cases RPR (+), 11 cases TPHA(+), 1 case FTA-ABS(+). After systemic treatment, 11 cases are clinically recovered. All patients serology become negative.

CONCLUSION

W-S staining method can directly demonstrate histopathologic characteristics in early syphilis, in intrinsic membrane numerous plasmacyte infiltration. Combining with specific syphilis serology examination could increase diagnosis rate of syphilis in nose and oropharynx.

摘要

目的

探讨早期梅毒螺旋体感染耳、鼻、口咽及喉部组织的特点,提高鼻及口咽部梅毒的检出率,增强医生的自我防护意识。

方法

对12例可疑梅毒活检组织采用HE染色观察组织病理特征,采用Warthin-Starry(W-S)染色检测病变组织及渗出物涂片中的梅毒螺旋体(TP)。通过性病研究实验室(VDRL)、快速血浆反应素环状卡片试验(RPR)、梅毒螺旋体血凝试验(TPHA)及荧光密螺旋体抗体吸收试验(FTA-ABS)进行确诊。采用国家公布的梅毒治疗方法进行治疗。

结果

12例黏膜标本中,鳞状上皮增生,中性粒细胞浸润,固有膜内大量浆细胞和淋巴细胞浸润。W-S染色:黏膜上皮及渗出物涂片中发现大量梅毒螺旋体。血清学检查:11例VDRL(++++),7例RPR(+),11例TPHA(+),1例FTA-ABS(+)。经系统治疗后,11例临床治愈。所有患者血清学均转阴。

结论

W-S染色法可直接显示早期梅毒的组织病理特征,固有膜内有大量浆细胞浸润。结合梅毒特异性血清学检查可提高鼻及口咽部梅毒的诊断率。

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