Rodríguez G, Sarmiento L
Department of Pathology, National Institute of Health, School of Medicine, National University, Bogotá, Colombia.
Am J Dermatopathol. 1998 Jun;20(3):246-9. doi: 10.1097/00000372-199806000-00004.
Some believe that asteroid bodies (AB) in sporotrichosis are nonspecific and are equivalent to the AB of sarcoidosis and other granulomatous diseases. We studied 25 skin biopsy specimens of sporotrichosis in which AB were demonstrated, ten of them with Sporothrix-positive culture. Immunohistochemistry was performed in paraffin-embedded biopsy specimens using an anti-Sporothrix antibody. The same procedures were done with seven biopsy specimens of lobomycosis, which contained AB within giant cells. These did not react with the anti-Sporothrix antibody, and by electron microscopy they displayed filamentous and myelin figures similar to the AB of sarcoidosis. In sporotrichosis, the AB are extracellular eosinophilic structures, 15-35 microm in diameter, and located within abscesses. One to three are found in a section. They consist of a central yeast, surrounded by eosinophilic spicules. The yeast stains with the anti-Sporothrix antibody, while the spicules do not. Therefore, AB in sporotrichosis are specific for disease. Visualization of the spicules alone can lead to the demonstration of the AB in adjacent sections, and thus is a useful clue in the diagnosis of sporotrichosis. Sporotrichotic AB must not be confused with the intracellular AB seen in giant cells of granulomatous reactions, which are filamentous and myelin figures that contain lipid.
一些人认为，孢子丝菌病中的星状体（AB）是非特异性的，等同于结节病和其他肉芽肿性疾病的星状体。我们研究了25例有星状体表现的孢子丝菌病皮肤活检标本，其中10例培养出申克孢子丝菌阳性。使用抗申克孢子丝菌抗体对石蜡包埋的活检标本进行免疫组织化学检测。对7例芽生菌病的活检标本也进行了同样的操作，这些标本在巨细胞内含有星状体。它们不与抗申克孢子丝菌抗体发生反应，并且通过电子显微镜观察显示出与结节病的星状体相似的丝状和髓鞘样结构。在孢子丝菌病中，星状体是细胞外嗜酸性结构，直径为15 - 35微米，位于脓肿内。在一个切片中可发现1至3个。它们由一个中央酵母组成，周围环绕着嗜酸性针状体。酵母可被抗申克孢子丝菌抗体染色，而针状体则不能。因此，孢子丝菌病中的星状体是该病特有的。仅针状体的可视化就能在相邻切片中显示出星状体，因此是孢子丝菌病诊断中的一个有用线索。孢子丝菌病的星状体绝不能与肉芽肿反应巨细胞内所见的细胞内星状体相混淆，后者是含有脂质的丝状和髓鞘样结构。
