Ehrmantant Wilfred R, Graham William P, Towfighi Javad, Mackay Donald R, Ehrlich H Paul
Division of Plastic Surgery and the Department of Pathology, Milton S. Hershey Medical Center, Hershey, PA 17033, USA.
Plast Reconstr Surg. 2004 Sep 1;114(3):721-7. doi: 10.1097/01.prs.0000131017.15574.a9.
The etiology of Dupuytren's disease is unknown. The causes of the fibroplastic response of nodules, fibrosis of cords, and prominence of pacinian corpuscles are not evident. Histological and immunohistology differences in pacinian corpuscles from the hands of five patients with Dupuytren's disease compared with 17 Dupuytren's-free patients are presented. Histological sections of pacinian corpuscle specimens were stained with hematoxylin and eosin and immunostained for nerve growth factor receptor. The length and width of intact pacinian corpuscles were measured, and the number of layers within each corpuscle was counted and recorded. Grossly, the pacinian corpuscles from Dupuytren's patients were larger and more numerous compared with those from unaffected patients. When measured microscopically, the pacinian corpuscles from Dupuytren's diseased fascia were significantly larger (2.0 x 1.1 mm) compared with controls (1.5 x 0.78 mm). The pacinian corpuscles from Dupuytren's-affected patients had significantly more layers (64 +/- 14) compared with those from control patients (40 +/- 9). Nerve growth factor receptor staining of pacinian corpuscles from patients affected with Dupuytren's disease showed greater intensity and more area stained compared with unaffected controls. It is suggested that nerve growth factor may be involved in the increased size of pacinian corpuscles in Dupuytren's-affected fascia. It is proposed that the cellular outgrowth from pacinian corpuscles may generate the cells that develop into Dupuytren's nodules.
掌腱膜挛缩症的病因尚不清楚。结节的纤维增生反应、条索状纤维化以及环层小体增大的原因尚不明确。本文呈现了5例掌腱膜挛缩症患者与17例未患掌腱膜挛缩症患者手部环层小体的组织学和免疫组织学差异。环层小体标本的组织切片用苏木精和伊红染色，并对神经生长因子受体进行免疫染色。测量完整环层小体的长度和宽度，计数并记录每个小体内的层数。大体上，与未患病患者相比，掌腱膜挛缩症患者的环层小体更大且数量更多。显微镜下测量时，掌腱膜挛缩症患者筋膜中的环层小体（2.0×1.1毫米）明显大于对照组（1.5×0.78毫米）。与对照组患者（40±9层）相比，患掌腱膜挛缩症患者的环层小体层数显著更多（64±14层）。与未患病对照组相比，掌腱膜挛缩症患者环层小体的神经生长因子受体染色显示强度更大且染色面积更广。提示神经生长因子可能与掌腱膜挛缩症患者筋膜中环层小体增大有关。有人提出，环层小体的细胞增生可能产生发展为掌腱膜挛缩症结节的细胞。
