Laboratório Avançado de Saúde Pública, Centro de Pesquisas Gonçalo Moniz, Fiocruz, Salvador, BA, Brasil.
Mem Inst Oswaldo Cruz. 2013 Feb;108(1):18-22. doi: 10.1590/s0074-02762013000100003.
Disseminated leishmaniasis (DL) differs from other clinical forms of the disease due to the presence of many non-ulcerated lesions (papules and nodules) in non-contiguous areas of the body. We describe the histopathology of DL non-ulcerated lesions and the presence of CD4-, CD20-, CD68-, CD31- and von Willebrand factor (vW)-positive cells in the inflamed area. We analysed eighteen biopsies from non-ulcerated lesions and quantified the inflamed areas and the expression of CD4, CD20, CD68, CD31 and vW using Image-Pro software (Media Cybernetics). Diffuse lymphoplasmacytic perivascular infiltrates were found in dermal skin. Inflammation was observed in 3-73% of the total biopsy area and showed a significant linear correlation with the number of vW+ vessels. The most common cells were CD68+ macrophages, CD20+ B-cells and CD4+ T-cells. A significant linear correlation between CD4+ and CD20+ cells and the size of the inflamed area was also found. Our findings show chronic inflammation in all DL non-ulcerated lesions predominantly formed by macrophages, plasmacytes and T and B-cells. As the inflamed area expanded, the number of granulomas and extent of the vascular framework increased. Thus, we demonstrate that vessels may have an important role in the clinical evolution of DL lesions.
播散性利什曼病（DL）与其他临床形式的疾病不同，因为它在身体非连续区域存在许多非溃疡性病变（丘疹和结节）。我们描述了 DL 非溃疡性病变的组织病理学和炎症区域中 CD4-、CD20-、CD68-、CD31-和血管性血友病因子（vW）阳性细胞的存在。我们分析了 18 份非溃疡性病变的活检，并使用 Image-Pro 软件（Media Cybernetics）定量了炎症区域和 CD4、CD20、CD68、CD31 和 vW 的表达。在真皮皮肤中发现弥漫性淋巴浆细胞血管周围浸润。炎症在总活检面积的 3-73%中观察到，与 vW+血管数量呈显著线性相关。最常见的细胞是 CD68+巨噬细胞、CD20+B 细胞和 CD4+T 细胞。还发现 CD4+和 CD20+细胞与炎症区域大小之间存在显著线性相关性。我们的研究结果表明，所有 DL 非溃疡性病变均存在慢性炎症，主要由巨噬细胞、浆细胞以及 T 和 B 细胞组成。随着炎症区域的扩大，肉芽肿的数量和血管结构的范围增加。因此，我们证明血管可能在 DL 病变的临床演变中发挥重要作用。
