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口腔结核的文献回顾及一例具有独特组织学表现的病例报告。

Literature review of oral tuberculosis and report of a case with unique histological presentation.

机构信息

Department of Periodontics, Maulana Azad Institute of Dental Sciences, Maulana Azad Medical College Campus, Bahadur Shah Zafar Marg, New Delhi, 110002, India.

Department of Periodontics, Maharashtra Institute of Dental Sciences & Research, Vishwanathpuram, Ambajogai Road, Latur, Maharashtra, 413531, India.

出版信息

Indian J Tuberc. 2020 Apr;67(2):238-244. doi: 10.1016/j.ijtb.2019.02.019. Epub 2019 Mar 7.

Abstract

As a consequence of the emergence of drug resistant tuberculosis (TB) and various immuno-compromised states, there is a re-emergence of many forgotten extrapulmonary manifestations of TB including oral TB, which must be taken into consideration while diagnosing oral lesions. The present article discusses the geographical burden, temporal evolution, demographic variables, clinical presentation and treatment of oral TB. The occurrence is most commonly secondary to pulmonary TB but oral symptoms may precede systemic symptoms. The most common presentation is ulceration (71%) and histopathological specimens demonstrate the characteristic epithelioid and langhans cells. In a unique case, presented here, an ulcerative tuberculous gingival lesion demonstrated dense plasma cell infiltration histologically and closely mimicked plasma cell gingivitis which made the diagnosis challenging.

摘要

由于耐药结核病(TB)和各种免疫功能低下状态的出现,许多被遗忘的肺外结核病表现形式(包括口腔结核病)再次出现,在诊断口腔病变时必须考虑到这些疾病。本文讨论了口腔结核病的地理负担、时间演变、人口统计学变量、临床表现和治疗。该病最常继发于肺结核,但口腔症状可能先于全身症状出现。最常见的表现是溃疡(71%),组织病理学标本显示特征性的上皮样细胞和朗汉斯巨细胞。在这里介绍的一个独特病例中,表现为溃疡性结核性牙龈病变,组织学上显示密集的浆细胞浸润,与浆细胞性龈炎非常相似,这使得诊断具有挑战性。

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