Kostianovsky M, Greco M A
Department of Pathology and Cell Biology, Thomas Jefferson University, Philadelphia, Pennsylvania.
Ultrastruct Pathol. 1994 May-Jun;18(3):349-55. doi: 10.3109/01913129409023203.
Eight cases of cutaneous bacillary angiomatosis related to acquired immunodeficiency syndrome were studied by light and electron microscopy and by immunohistochemistry with a panel of antibodies specific for endothelial and histiocytic markers. Light microscopy showed an inflammatory reaction with florid neovascularization and clusters of Warthin-Starry-positive bacilli. In addition, solid areas of spindle cells were also present that in some cases mimicked Kaposi's sarcoma or other sarcomas. The investigation focused primarily on the spindle cell areas and the angiogenic process present in bacillary angiomatosis. By immunohistochemistry the lesions, including the spindle cell areas, expressed all endothelial markers used; CD34, factor VIII-related antigen, and Ulex europaeus 1 were the most consistent in intensity, however. In those areas the other endothelial markers, BNH9 and Psophocarpus tetragonolobus, were weak and not always uniform. The macrophage/monocyte markers used were alpha 1-antitrypsin, lysosome, kp1 (CD68), and polyclonal factor XIIIa; these revealed a sprinkle of positive cells ranging from 10% to 20% of the cell population. By electron microscopy primitive capillaries were present lined by plump endothelial cells containing frequent abluminal microprocesses forming intercellular lumina. Mitoses and intracytoplasmic lumen formation were infrequent. The study illustrates that bacillary angiomatosis is composed of active endothelial neoformation with the spindle cells representing immature endothelial cells. Furthermore, the features of this angiogenic process recapitulate the morphologic events described in experimental models.
对8例与获得性免疫缺陷综合征相关的皮肤杆菌性血管瘤病患者进行了光镜、电镜检查以及免疫组织化学研究，使用了一组针对内皮细胞和组织细胞标志物的抗体。光镜检查显示存在炎症反应，伴有大量新生血管形成以及沃辛-斯塔里染色阳性的杆菌簇。此外，还存在梭形细胞实性区域，在某些情况下可类似卡波西肉瘤或其他肉瘤。研究主要聚焦于杆菌性血管瘤病中存在的梭形细胞区域和血管生成过程。通过免疫组织化学，包括梭形细胞区域在内的病变表达了所有使用的内皮细胞标志物；不过，CD34、因子VIII相关抗原和荆豆凝集素1在强度上最为一致。在这些区域，其他内皮细胞标志物BNH9和四角豆凝集素呈弱阳性且并非总是均匀一致。所使用的巨噬细胞/单核细胞标志物为α1-抗胰蛋白酶、溶酶体、kp1（CD68）和多克隆因子XIIIa；这些标志物显示有少量阳性细胞，占细胞总数的10%至20%。电镜检查显示存在原始毛细血管，其内衬丰满的内皮细胞，这些内皮细胞含有频繁的腔外微突起，形成细胞间腔隙。有丝分裂和胞质内管腔形成较少见。该研究表明，杆菌性血管瘤病由活跃的内皮细胞新生组成，其中梭形细胞代表未成熟的内皮细胞。此外，这一血管生成过程的特征概括了实验模型中所描述的形态学事件。
