Barrett A W, Villarroel Dorrego M, Hodgson T A, Porter S R, Hopper C, Argiriadou A S, Speight P M
Oral and Maxillofacial Pathology, Eastman Dental Institute for Oral Healthcare Sciences, UCL, University of London, 256 Grays Inn Road, London, WC1X 8LD, UK.
J Oral Pathol Med. 2004 May;33(5):286-91. doi: 10.1111/j.0904-2512.2004.00099.x.
Reported cases of syphilis in the United States, Europe and elsewhere are increasing in number. Clinical manifestations are protean, and oral biopsies may be taken where the diagnosis is unsuspected, but data on the histopathology of oral mucosal syphilis are sparse.
The histopathology of five oral lesions in patients with serologically proven syphilis was reviewed.
There were two cases of primary syphilis, one secondary and two tertiary. Epithelial hyperplasia was present in three cases, and was pseudocarcinomatous in one case of primary syphilis, and psoriasiform in the secondary lesion, where heaped-up epithelium surrounded a defined crater covered by flatter epithelium. Plasma cell (primary and secondary disease) and granulomatous (tertiary) infiltrates were prominent. Other features observed were endarteritis (5/5), plasma cell neuritis (3/5) and spirochetes (4/5).
Although no single microscopic feature is specific, a diagnosis of syphilis should be considered where there is unusual epithelial hyperplasia, granulomatous or plasma cell-predominant chronic inflammation, endarteritis and neuritis.
美国、欧洲及其他地区报告的梅毒病例数量正在增加。梅毒的临床表现多样，在诊断未被怀疑时可能会进行口腔活检，但关于口腔黏膜梅毒组织病理学的数据却很稀少。
回顾了血清学确诊梅毒患者的5例口腔病变的组织病理学情况。
有2例一期梅毒、1例二期梅毒和2例三期梅毒。3例出现上皮增生，其中1例一期梅毒表现为假癌样增生，1例二期病变表现为银屑病样增生，增生的上皮堆积围绕着一个由较扁平上皮覆盖的明确溃疡。浆细胞浸润（一期和二期病变）和肉芽肿性浸润（三期病变）较为显著。观察到的其他特征包括动脉内膜炎（5/5）、浆细胞神经炎（3/5）和螺旋体（4/5）。
虽然没有单一的微观特征具有特异性，但当出现异常上皮增生、肉芽肿性或以浆细胞为主的慢性炎症、动脉内膜炎和神经炎时，应考虑梅毒的诊断。
