鼻腔鼻窦曲霉菌病103例病理学观察

Pathological observation of 103 cases with aspergillosis of the nasal and paranasal sinus

目的观察和分析鼻腔鼻窦曲霉菌病的病理形态特征,以加深认识,提高诊断水平。方法回顾性观察2012-2018年间收到的鼻腔鼻窦活检切片,并用过碘酸席夫染色(PAS)和六胺银染色(GMS)进一步验证,分析其病理特征。结果确认103例鼻腔鼻窦曲霉菌病,均为非浸润性,其中101例为曲霉菌球,2例为变应性曲霉菌病。曲霉菌球多数由菌丝缠绕交织呈团块状,部分呈分层状结构,并可见曲霉菌变性、坏死、钙化,伴炎细胞浸润。结论曲霉菌感染是鼻腔鼻窦真菌性炎症的重要原因,常形成曲霉菌球。特殊染色(PAS和GMS)有助于确认真菌形态。

Objective To observe and analyze the pathological features of aspergillosis of nasal cavity and sinus in order to deepen the understanding and improve the diagnostic level.Methods The nasal cavity and sinus biopsy sections received by the department from 2012 to 2018 were reviewed retrospectively,and further verified by peroidic acid Schiff(PAS)staining and Grocott methenanine silver(GMS)staining to analyze their pathological characteristics.Results 103 cases of aspergillosis of the nasal cavity and sinus were confirmed to be non-invasive type,including 101 cases of aspergillusballs(aspergillomas)and 2 cases of allergic aspergillosis.Most aspergillus balls were clumped by mycelium(hyphae)winding and interweaving,and some were stratified,with aspergillus degeneration,necrosis and calcification,accompanied by inflammatory cell infiltration.Conclusion Aspergillus infection is an important cause of fungal rhinosinusitis with aspergilloma formation usually.Specific staining(PAS and GMS)may help to confirm fungal morphology.