R G Neves, M D Hahn, L M Bechelli, E Melchior Júnior, P M Pagnano, N Haddad
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引用次数: 0
摘要
对不同临床分型和不同分组的汉森病进行了Ridley-Jopling (RJ)和Congress of Madrid (CM)病理标准的比较研究。在不确定组和Virchowian (V),结核样(T)和反应性结核样(RT)型的退化阶段,发现两个标准之间的一致性。根据CM, 81.2%的病例经病理证实为临床RT,而根据RJ, 46.2%的病例被认为是“边缘性”。在48例临床V型患者中,17例(35.4%)为“边缘型”(BL-2、BL-1和BB),但根据CM,几乎所有患者在病理上也是V型。结论是,在建立不完全符合临床标准的组织病理学亚组方面没有实际的便利。作者强调研究V型浸润中的浆细胞,所有肉芽肿中的淋巴细胞以及神经末梢受累的差异的重要性,特别是在T极和V极之间。苏丹ⅲ染色脂质有助于完善V极的表征,识别残留的V结构,区分BT、BB和BL亚群,有助于V浸润的早期诊断和鉴别水肿、弥漫性、非颗粒性的RT细胞质空泡化。
[Comparative analysis of the clinical diagnosis of hanseniasis and the histopathological examinations performed according to the criteria of the Madrid and Ridley-Jopling classifications].
A comparative study of the Ridley-Jopling's (RJ) and of the Congress of Madrid's (CM) pathological criteria was made in the different clinical types and groups of hanseniasis. A concordance between both criteria was found in the Indeterminate group and in the regressive phases of the Virchowian (V), Tuberculoid (T) and Reactional tuberculoid (RT) types. Clinical RT was confirmed by pathology in 81.2% of the cases according to CM, whereas 46.2% were considered "Borderline" according to RJ. Out of the 48 clinically V patients, 17 (35.4%) were "Borderline" (BL-2, BL-1 and BB), but practically all were also pathologically V according to CM. It is concluded that there is no practical convenience in the establishment of histopathological sub-groups that do not perfectly agree with clinical criteria. The Authors stress the importance of the study of the plasmocytes in the V infiltrates, of the lymphocytes in all granulomas and of the differences in the involvement of the neural ends, specially between the T and V poles. The dyeing of lipids by the Sudan III is useful to perfectly characterize the V pole, recognize residual V structures, separate the sub-groups BT, BB and BL, help in the early diagnosis of V infiltrations and differentiate the edematous, diffuse, non-granular cytoplasmatic vacuolization of RT.