19例口面部肉芽肿病临床及组织病理分析

Clinicopathologic analysis of orofacial granulomatosis: a 19-case report

目的：探讨口面部肉芽肿病（OFG）临床、组织病理特征及局部肿胀的机制。方法：对19例OFG患者的临床和组织病理资料进行回顾性分析,并进行CD68、CD31和D2-40免疫组化染色。结果：19例OFG患者中,男7例,女12例,年龄13~76岁,平均50.32岁。皮损以唇最常见,占100%,表现为持续性非凹陷性浸润性肿胀和红斑。OFG组织病理特征为真皮内上皮样肉芽肿形成,中心无坏死。17例患者（89.47%）可见肉芽肿围绕D2-40阳性的淋巴管形成,13例患者（68.42%）可见肉芽肿位于D2-40阳性的淋巴管内。结论：OFG可侵犯面部多部位,上皮样肉芽肿是其主要组织病理特征,淋巴管阻塞及淋巴引流障碍是其局部肿胀的病理机制。

Objective： To analyze the clinicopathological features of orofacial granulomatosis （OFG） and possible mechanism of its localized edema. Methods： The clinical and pathological data of 19 cases of OFG were retrospectively analyzed. And immunohistochemical staining of CD68, CD31 and D2-40 was also analyzed. Results： 19 cases of OFG included 7 males and 12 females, aged 13 to 76 years old, with an average age of 50.32 years. Involvement of the lip accounted for 100% of the patients. The primary manifestation of OFG was persistent, non-pitting edematous erythema, and its histopathological feature was non-caseating epithelioid granulomas in the dermis. The granulomas around and within D2-40 positive lymphatic vessels were found in 17 cases （89.47%） and 13 cases （68.42%）, respectively. Conclusion： OFG may involve multiple sites of the face, and epithelioid granuloma is its main pathological feature. Lymphatic blockage and impaired lymphatic drainage are the pathological mechanisms of its swelling.