口腔黏膜增殖性天疱疮的组织病理学特征

Histopathological features of oral pemphigus vegetans

目的研究口腔黏膜慢性增殖性天疱疮的临床组织病理学特征.方法对7例口腔黏膜慢性增殖性天疱疮患者的临床表现及病理学切片进行分析.结果 7例患者中5例女性,2例男性,平均52.7岁.病程3个月～10年.口腔黏膜表现为斑块状或疣状增生,伴有广泛的水肿、糜烂及渗出,可有结痂形成.5例患者伴有增生性皮肤改变.组织病理学观察显示:病变区上皮增生,钉突延长;上皮内形成深棘层细胞间或棘层与基底层间的裂隙或疱,邻近裂隙的上皮中可见细胞间水肿;上皮内及上皮下有嗜酸性细胞浸润并可在上皮内形成嗜酸性微脓肿;固有层存在炎症性变化.结论口腔黏膜慢性增殖性天疱疮的上述病理变化特点对于该病的病理学诊断具有重要意义.

Objective To investigate the clinicopathological features of oral pemphigus vegetans. Methods Seven cases of pemphigus vegetans involving oral mucosa were included in this study. The paraffin sections were analyzed by routine light microscope. Results There were 5 females and 2 males in this group, with an average age of 52.7 years. The course of diseases was from 3 months to 10 years. Oral manifestations included verrucous or papilliform hyperplasia of oral mucosa, with extensive edema and exudation. Similar skin lesions were found in 5 patients. Under the microscope, pemphigus vegetans showed epithelial thickening with prolonged rete pegs, intraepithelial clefts in suprabasal cells. Eosinophilic microAbscesses was often seen within the epithelium. Other microscopic changes were intraepithelial edema and eosinophils infiltration, chronic inflammatory cells infiltration in the lamina propria. Conclusion The microscopic features pemphigus vegetans described in this study are of valuable for pathological diagnosis of oral pemphigus vegetans.