Sakai T, Kawaguchi M, Ishizawa S, Kaji T, Kitagawa K, Koizumi F
Second Department of Pathology, Toyama Medical and Pharmaceutical University, Faculty of Medicine, Japan.
Pathol Int. 1994 Mar;44(3):186-93. doi: 10.1111/j.1440-1827.1994.tb02591.x.
The morphological expression of the immune response of palatine tonsils obtained from patients with pustulosis palmaris et plantaris (PPP) was investigated by morphometry in conjunction with immunohistochemistry. First, to differentiate the histological features of tonsils between PPP and habitual tonsillitis, each extent of the T cell dependent areas (T nodules), B cell dependent areas (lymph follicles), germinal centers, mixed areas of T cells and B cells, and lacunar epithelium was measured and compared on 38 patients with PPP and 47 with habitual tonsillitis, respectively. The most remarkable findings in PPP were enlargement of the secondary T nodules, and atrophy of the lymph follicles with a decrease in number of the germinal center cells and fibrosis. These changes of lymph follicles were similar to those in the older patients with habitual tonsillitis, which suggests the intensely advanced stage of the immune response within the tonsils. Second, the histological structures of the tonsils of 15 tonsillectomy effective cases (88.2%) was compared with those of two non-effective cases in curing skin lesions. The histological structure in the non-effective cases was very similar to that in habitual tonsillitis cases. This indicates that the histological findings may be useful in predicting the effects of tonsillectomy on PPP.
采用形态计量学结合免疫组织化学方法，对掌跖脓疱病（PPP）患者腭扁桃体免疫反应的形态学表现进行了研究。首先，为区分PPP患者与习惯性扁桃体炎患者扁桃体的组织学特征，分别对38例PPP患者和47例习惯性扁桃体炎患者的T细胞依赖区（T小结）、B细胞依赖区（淋巴滤泡）、生发中心、T细胞和B细胞混合区以及陷窝上皮的范围进行了测量和比较。PPP患者最显著的表现是次级T小结增大，淋巴滤泡萎缩，生发中心细胞数量减少且纤维化。这些淋巴滤泡的变化与老年习惯性扁桃体炎患者相似，提示扁桃体免疫反应处于高度进展阶段。其次，比较了15例扁桃体切除有效病例（88.2%）与2例皮肤病变治疗无效病例扁桃体的组织结构。无效病例的组织结构与习惯性扁桃体炎病例非常相似。这表明组织学表现可能有助于预测扁桃体切除术对PPP的疗效。
