el-Mofty S K, Swanson P E, Wick M R, Miller A S
Department of Pathology, Washington University School of Medicine, St. Louis.
Oral Surg Oral Med Oral Pathol. 1993 Jun;75(6):716-22. doi: 10.1016/0030-4220(93)90429-8.
Eosinophilic ulcer of the oral mucosa (traumatic eosinophilic granuloma) mimics oral cancer clinically and is occasionally misdiagnosed as lymphoma on microscopic examination. Trauma is believed to play a role in its development, but its exact pathogenesis is not known. The demographic, clinical, and histologic features of 38 previously unreported cases of eosinophilic ulcer of the oral mucosa are reviewed. Nine representative cases were studied immunohistochemically. Microscopically, the lesions contained a polymorphic inflammatory infiltrate extending deep into the submucosa, underlying muscle, and salivary glands. Numerous eosinophils and large mononuclear cells with pale nuclei and frequent mitoses were seen in all lesions. Lymphocytes, histiocytes, plasma cells, granulocytes, and mast cells were also present. Immunohistochemical stains showed that the lymphocytic infiltrate was composed predominantly of T cells. T-cell-specific antigen-presenting cells were more numerous than the non-antigen-presenting cell type. The large cells with pale nuclei stained positively only for vimentin; the possible myofibroblastic nature of these cells is discussed. Although trauma might have an etiologic role, the pathogenesis of eosinophilic ulcer of the oral mucosa is probably T cell mediated.
口腔黏膜嗜酸性溃疡（创伤性嗜酸性肉芽肿）在临床上类似口腔癌，偶尔在显微镜检查时被误诊为淋巴瘤。创伤被认为在其发病过程中起作用，但其确切发病机制尚不清楚。本文回顾了38例既往未报道的口腔黏膜嗜酸性溃疡病例的人口统计学、临床和组织学特征。对9例具有代表性的病例进行了免疫组织化学研究。显微镜下，病变包含多形性炎性浸润，深入至黏膜下层、下方肌肉和唾液腺。所有病变中均可见大量嗜酸性粒细胞以及具有淡染细胞核和频繁有丝分裂的大单核细胞。淋巴细胞、组织细胞、浆细胞、粒细胞和肥大细胞也存在。免疫组织化学染色显示淋巴细胞浸润主要由T细胞组成。T细胞特异性抗原呈递细胞比非抗原呈递细胞类型更多。淡染细胞核的大细胞仅波形蛋白染色呈阳性；讨论了这些细胞可能的肌成纤维细胞性质。尽管创伤可能具有病因学作用，但口腔黏膜嗜酸性溃疡的发病机制可能是T细胞介导的。
