Kaminagakura E, Bonan P R F, Jorge J, Almeida O P, Scully C
Department of Oral Pathology, Piracicaba Dental School, University of Campinas, São Paulo, Brazil.
Oral Dis. 2007 Jul;13(4):434-9. doi: 10.1111/j.1601-0825.2006.01319.x.
Paracoccidioidomycosis (Pmycosis) is one of the most common deep mycoses in many regions of Latin America, particularly in Brazil. Microscopically, it shows granulomatous inflammatory reaction with giant cells, macrophages, lymphocytes, plasma cells, polymorphonuclear neutrophilic leukocytes, and eosinophils. The purpose of this study was to assess the distribution of inflammatory cells in oral Pmycosis. Fifteen cases of oral Pmycosis were studied by immunohistochemistry for the presence of macrophages, CD4(+) and CD8(+) lymphocytes, CD20(+), CD15(+), and S100(+) cells. Macrophages were the main cells in well-organized granulomas and non-granulomatous areas. The CD4 phenotype was predominant in well-organized granulomas and a balance between CD4(+) and CD8(+) cells was observed in non-granulomatous areas. Dendritic, S100(+) cells were found mainly in the epithelium, in subepithelial connective tissue, and at the periphery of organized granulomas. CD15(+) cells were concentrated mainly in areas of intraepithelial microabscess and ulceration. Macrophages and T cells are the predominant cells in oral Pmycosis. Well-organized granulomas contain fewer yeast particles, indicating a more effective host immune response. Better understanding of the histopathological changes in oral Pmycosis might help determine treatment, severity and systemic involvement of the disease.
副球孢子菌病是拉丁美洲许多地区最常见的深部真菌病之一，在巴西尤为常见。在显微镜下，它表现为伴有巨细胞、巨噬细胞、淋巴细胞、浆细胞、多形核中性粒细胞和嗜酸性粒细胞的肉芽肿性炎症反应。本研究的目的是评估口腔副球孢子菌病中炎症细胞的分布情况。通过免疫组织化学研究了15例口腔副球孢子菌病，以检测巨噬细胞、CD4(+)和CD8(+)淋巴细胞、CD20(+)、CD15(+)和S100(+)细胞的存在情况。巨噬细胞是结构良好的肉芽肿和非肉芽肿区域的主要细胞。CD4表型在结构良好的肉芽肿中占主导地位，在非肉芽肿区域观察到CD4(+)和CD8(+)细胞之间的平衡。树突状S100(+)细胞主要见于上皮、上皮下结缔组织以及有组织的肉芽肿周边。CD15(+)细胞主要集中在上皮内微脓肿和溃疡区域。巨噬细胞和T细胞是口腔副球孢子菌病中的主要细胞。结构良好的肉芽肿中酵母颗粒较少，表明宿主免疫反应更有效。更好地了解口腔副球孢子菌病的组织病理学变化可能有助于确定该疾病的治疗、严重程度和全身受累情况。
