原发性肺隐球菌病的光镜和超微结构观察

Microscopic and ultrastructural observation of primary pulmonary cryptococcosis

目的 探讨原发性肺隐球菌病 (PC)的超微结构特点及其在PC诊断中的作用。方法 对 2例外科手术切除的PC进行组织化学染色、光镜和透射电镜观察。结果 光镜观察见PC病变有非干酪性肉芽肿形成 ,作粘液卡红 (MC)、过碘酸雪夫氏染色 (PAS)和Grocott六胺银 (GMC)染色发现新型隐球菌 (CN)呈阳性染色。透射电镜观察见CN有细胞壁、细胞质和荚膜 ,细胞器不发达 ,未见细胞核 ,大部分细胞退变。结论 在活体组织内CN的超微结构不发达 ,电镜观察有助于对PC做出明确诊断及鉴别诊断。

Objective To investigate the ultrastructural features of primary pulmonary cryptococcosis (PC) and its roles in the pathologic diagnosis. Methods Two cases of PC were observed by light and electron microscopy and histochemical staining. Results The histopathological examination found cryptococcosis granuloma formation in the 2 cases, and the cryptococcous neoformans (CN) were detected in mucicarmine (MC), periodic acid-Schiff (PAS), and Grocot's methenamine-silver (GMS), respectively. Electron microscopy revealed that most of CN had a simple structure and a few organells. The cell wall, cytoplasm, and capsule could be seen, and part of them had nuclei. Conclusion The ultrastructure of CN is simple. Electron microscopic observation is helpful for the correct diagnosis and differential diagnosis of PC.