Gibson D W, Connor D H
Trans R Soc Trop Med Hyg. 1978;72(2):137-54. doi: 10.1016/0035-9203(78)90049-4.
Clinicopathological studies on lymph nodes of 32 Africans with onchocerciasis--some complicated by hanging groin and elephantiasis of the genitalia--revealed atrophic lymphoid tissue, lymphoedema, chronic inflammation and fibrosis. We identified microfilariae of Onchocerca volvulus in nodes of 24 of 32 Africans (75%). There microfilariae were most numerous in the capsule and in the fibrous tissue of the medulla, but smaller numbers were also found within lymphoid tissue, in dilated lymphatics and in blood vessels. We believe that in Africians, antigens released from microfilariae of O. volvulus lead to the deposition of immune complex in tissues, which in turn causes inflammation and fibrosis and eventually obstructive lymphadenitis. This causes hanging groin and, possibly, also elephantiasis. A distinctive pattern of perivascular fibrosis contains "fibrinoid material" that we interpret as immune complexes involving microfilarial antigens. In contrast, nodes from two Yemenites with severe onchocercal dermatitis of the lower limbs (sowda) had hyperplastic follicles, minimal fibrosis and no microfilariae.
对32名患有盘尾丝虫病的非洲人淋巴结进行的临床病理研究——其中一些伴有腹股沟下垂和生殖器象皮肿——显示出萎缩的淋巴组织、淋巴水肿、慢性炎症和纤维化。我们在32名非洲人的24名（75%）的淋巴结中发现了盘尾丝虫微丝蚴。这些微丝蚴在被膜和髓质的纤维组织中最多，但在淋巴组织、扩张的淋巴管和血管中也发现了较少数量。我们认为，在非洲人中，盘尾丝虫微丝蚴释放的抗原导致免疫复合物在组织中沉积，进而引起炎症和纤维化，最终导致阻塞性淋巴结炎。这会导致腹股沟下垂，也可能导致象皮肿。一种独特的血管周围纤维化模式含有“纤维蛋白样物质”，我们将其解释为涉及微丝蚴抗原的免疫复合物。相比之下，两名患有严重下肢盘尾丝虫性皮炎（sowda）的也门人淋巴结有滤泡增生、纤维化轻微且无微丝蚴。
