CAJ | 학술논문

目的探讨特殊染色技术在艾滋病合并真菌病理诊断中的应用价值.方法选取2010年2月至2013年11月上海市(复旦大学附属)公共卫生临床中心确诊为艾滋病合并真菌感染的患者20例,回顾性分析经苏木素-伊红(HE)染色、过碘酸希夫染色(PAS)和六胺银染色的病理资料,观察常见真菌在光镜下的形态.结果 20例艾滋病合并真菌感染的患者中,肺部隐球菌2例,皮肤、肺、腹腔肠系膜淋巴结马尔尼菲青霉菌3例,会厌、颈部淋巴结、口腔、腹腔及皮肤组织胞浆菌5例,上颌窦、肺及声带曲霉4例(合并结核3例),肝、咽、食道及胃部白色假丝酵母菌6例.HE染色组织中炎性细胞浸润,可见肉芽肿形成,凝固性坏死,真菌形态尚能辨认,但需仔细观察,否则易漏诊或误诊;PAS染色,真菌孢子和假菌丝呈亮丽的紫红色,细胞核紫蓝色;六胺银染色,真菌孢子和假菌丝呈清晰可辨的黑褐色.结论除常规进行HE染色外,联合应用PAS染色和六胺银染色,有助于提高真菌的病理诊断率.
목적 탐토특수염색기술재애자병합병진균병리진단중적응용개치.방법 선취2010년2월지2013년11월상해시(복단대학부속)공공위생림상중심학진위애자병합병진균감염적환자20례,회고성분석경소목소-이홍(HE)염색、과전산희부염색(PAS)화륙알은염색적병리자료,관찰상견진균재광경하적형태.결과 20례애자병합병진균감염적환자중,폐부은구균2례,피부、폐、복강장계막림파결마이니비청매균3례,회염、경부림파결、구강、복강급피부조직포장균5례,상합두、폐급성대곡매4례(합병결핵3례),간、인、식도급위부백색가사효모균6례.HE염색조직중염성세포침윤,가견육아종형성,응고성배사,진균형태상능변인,단수자세관찰,부칙역루진혹오진;PAS염색,진균포자화가균사정량려적자홍색,세포핵자람색;륙알은염색,진균포자화가균사정청석가변적흑갈색.결론 제상규진행HE염색외,연합응용PAS염색화륙알은염색,유조우제고진균적병리진단솔.
Objective To apply special staining techniques in pathological diagnosis of fungal infections in HIV/AIDS patients.Methods Pathological data of 20 HIV/AIDS patients complicated with fungi infections in Shanghai Public Health Clinical Center during February 2010 and November 2013 were retrospectively analyzed.Tissue specimens were stained with hematoxylin and eosin (HE),Periodic acidSchiff (PAS) and methenamine silver nitrate (MSN),and the sections were observed under optical microscope.Results Among 20 HIV/AIDS patients complicated with fungi infections,2 were infected with pulmonary cryptococcosis; 3 were penicillium marneffei infections in skin,lung and abdominal mesenteric lymph nodes; 5 were histoplasma capsulatum infections in epiglottis,neck lymph nodes,oral cavity,abdominal cavity and skin; 4 were aspergillus infections in maxillary sinus,lung and vocal cords,and 3 of them were combined with tuberculous lesions; 6 were candida albicans infections in liver,pharynx,esophagus and stomach.In tissues stained with HE the infiltration of inflammatory cells,granuloma formation and coagulative necrosis were observed,and the shape of fungi needed careful observation to avoid missed diagnosis and misdiagnosis.In tissues stained with PAS,fungal spores and pseudohypha were presented in bright amaranth,and cell nucleus was in purple-blue.In tissues stained with MSN,fungal spores and pseudohypha were identified clearly in brown-black.Conclusion HE plus PAS and MSN staining will help pathological diagnosis of fungi infection.