38例面中线部位难治性溃疡病理及免疫病理学研究

A PATHOLOGICAL AND IMMUNOPATHOLOGICAL STUDY ON 38 CASES OF INTRACTABLE FACIAL MIDLINE ULCERS

目的提供病理学依据以指导临床医师合理、有效的治疗。方法通过３８例面中线部位难治性溃疡病理及ＩｇＡ、ＩｇＧ、ＩｇＭ、κ、λ、Ｌ２６、ＵＣＨＬ１、ＬＣＡ、ＥＭＡ、ｋｅｒａｔｉｎ共１０种抗体免疫病理学进行研究。结果将溃疡归纳为９种基本病理形态学改变，免疫病理表明部分病例血管壁及间质内ＩｇＧ、ＩｇＡ沉积。Ｔ细胞局灶性增生病例经随访发现可发展为Ｔ细胞性淋巴瘤或坏死性肉芽肿。结论免疫病理检查对明确病变性质和早期诊断具有重要价值。溃疡基本病变病理分类为临床医师合理有效地治疗提供理论依据。

Objective To provide pathological information for ENT surgeons to make correct diagnosis and rational treatment of facial midline ulcers.Methods Thirty eight biopsy specimens were studied by histopathology and 10 immunopathological tests,including those of IgG,IgA,κ,λ,L26,UCHL1,LCA,EMA and keratin.Results Morphologically,the lesions could be described in 9 types.Immunopathological study revealed deposition of IgG and IgA in the blood vesssel walls and interstitial space in certain specimens.Followup showed focal proliferation of T cells might evolve into Tcell lymphoma or necrotic granuloma.Conclusion Immunopathological examination is valuable for determining the nature of the ulcerative lesion and arriving at early diagnosis.The classification of the lesion helps the doctor treat it effectively and rationally. 