Arias-Stella J, Lieberman P H, Erlandson R A, Arias-Stella J
Am J Surg Pathol. 1986 Sep;10(9):595-610. doi: 10.1097/00000478-198609000-00002.
Twenty-six verruga peruana nodules were studied. The presence of Factor VIII-related antigen and Ulex europaeus lectin binding, and the ultrastructural finding of rudimentary cell junctions and pinocytotic vesicles establish the endothelial character of the proliferating cells in the verruga nodules. Whereas superficial lesions could show an angiomatoid pattern, deep-situated nodules tended to present a compact type of growth. Electron-microscopic studies have shown that Bartonella bacilliformis was found abundantly in the extracellular spaces in the florid lesions and that no organisms were present in the late, resolving subcutaneous nodules. Although no true intracellular "viable" microorganisms were noted, pseudopods of cytoplasm entrapping one or two bacteria and surrounding matrix substance were seen often. The characteristics of cytoplasmic inclusions previously described in verruga cells as "chlamydozoa" were detailed. The ultrastructure of the inclusions corresponded to endothelial phagocytic cells in which complex invaginations of the cell surface had produced a labyrinth of interconnected channels and vacuoles containing degraded bacteria, extracellular matrix components, or both. We conclude that in light microscopy the finding of Rocha-Lima's inclusions is the only definite morphologic evidence of the presence of bartonella in verruga lesions.
对26个秘鲁疣结节进行了研究。VIII因子相关抗原和荆豆凝集素结合的存在，以及原始细胞连接和吞饮小泡的超微结构发现，确定了疣结节中增殖细胞的内皮特征。浅表病变可呈血管瘤样模式，而深部结节倾向于呈现致密型生长。电子显微镜研究表明，在活跃病变的细胞外间隙中大量发现了杆菌状巴尔通体，而在后期消退的皮下结节中未发现微生物。虽然未观察到真正的细胞内“活”微生物，但经常可见包裹一两个细菌和周围基质物质的细胞质伪足。详细描述了先前在疣细胞中描述为“衣原体”的细胞质内含物的特征。内含物的超微结构对应于内皮吞噬细胞，其中细胞表面的复杂内陷产生了包含降解细菌、细胞外基质成分或两者的相互连接的通道和液泡的迷宫。我们得出结论，在光学显微镜下，罗查-利马内含物的发现是疣病变中存在巴尔通体的唯一明确形态学证据。
