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目的:探讨早期蕈样肉芽肿(MF)的组织病理要点、光疗前后组织病理变化,为早期诊断以及光疗治疗提供病理上的支持。方法:收集24例经组织病理检查证实为MF患者光疗前后的48份皮损组织标本。分析光疗前后亲表皮性、角质层变化、表皮变化、炎性浸润模式、血管扩张、真皮纤维化、以及其他真皮变化。结果:治疗前后皮损组织标本的病理表现在淋巴细胞表皮Paget样分布(χ~2=4.55,P<0.05)、Pautrier微脓肿(χ~2=10.08,P<0.01)、真皮苔藓样浸润(χ~2=6.0,P<0.05)及纤维化(χ~2=14.84,P<0.01)等方面差异有统计学意义。结论:光疗是治疗早期MF的有效方法。光疗可以改变MF亲表皮性、真皮浸润模式、纤维化程度以及血管扩张。在组织病理上判断治疗是否有效以及描述光疗治疗早期MF病理变化时应注意亲表皮性、真皮浸润模式、纤维化程度以及血管扩张的改变。
Objective: To investigate the histopathological features of early stage mycosis fungoides (MF), histopathological changes before and after phototherapy and provide pathological support for early diagnosis and phototherapy. Methods: Totally 48 lesions were collected before and after phototherapy in 24 MF patients confirmed by histopathological examination. The changes of epidermis, cuticular changes, epidermal changes, inflammatory infiltration patterns, vasodilation, dermal fibrosis, and other dermal changes were analyzed before and after phototherapy. Results: The histopathological features of the lesions before and after the treatment were Paget-like (P <0.05), Pautrier micro abscess (χ ~ 2 = 10.08, P <0.01) χ ~ 2 = 6.0, P <0.05) and fibrosis (χ ~ 2 = 14.84, P <0.01). Conclusion: Phototherapy is an effective treatment for early MF. Phototherapy can change MF pro skin, dermal infiltration, fibrosis and vasodilation. In histopathology to determine whether the treatment is effective and describe the early phototherapy of MF pathological changes should pay attention to the pro-epidermal, dermal infiltration patterns, degree of fibrosis and vasodilation changes.