中华皮肤科杂志 ›› 1984, Vol. 17 ›› Issue (2): 85-87.

• 论著 • 上一篇    下一篇

结核样型麻风外周神经病变的电镜观察

吉重敏1, 刘子君1, 方郭锡2   

  1. 1. 中山医学院病理解剖教研室;
    2. 广州市皮肤病防治所
  • 出版日期:1984-06-15 发布日期:1984-06-15

Electron microscopic study on peripheral nerve lesions in tuberculoid leprosy

Ji Zhongmin1   

  • Online:1984-06-15 Published:1984-06-15

摘要: 本文报告5例结核样型麻风(TT)患者外周神经的超微结构改变,其中3例光镜下为活动二期,2例为消退期.电镜下观察:(1)活动期病变见神经纤维大部崩解,由上皮样细胞、淋巴细胞、巨噬细胞及纤维母细胞所取代.残存的神经纤维多为无髓鞘或脱髓鞘,轴突可呈不同程度的变性.病变内还可见个别中性白细胞、轻度胶原纤维增生及毛细血管的改变.文中对这些改变出现的意义进行了讨论.此外,在巨噬细胞内仍可见完整的或变性的麻风杆菌.(2)消退期病变可见上皮样细胞的变性,淋巴细胞增多及明显胶原纤维增生.本文对结核样型麻风外周神经病变的发生、麻风菌入侵外周神经的途径等问题也进行了讨论.

Abstract: Ultrastructural changes in peripheral nerve bio-psies from 5 cases.of tuberculoid leprosy, including 3 cases of active stage and 2 cases of regressive stage, were studied. Under electron microscopy, the nerve parenchyma from active stage was almost destroved and replaced by epithelioid cells, lymphocytes, macrophages and fibroblasts. Still some unmyel-inated and demyeliaated nerve fibers with intact or degenerated axon were seen amoag these cells. Occ-asionally polpmorphonuclear leucocytes, more or less collagen fibrils along with the changes in capillary walls were also found. Both intact and degenerated M. Ieprae could be seen in the cytoplasm of macrophages only after careful search, The predominapt feature of nerves from regressive stage was degenerated epithelioid cells, increasing number of lymphocytes and abundant formation of collagen fibrils. The pathogenesis of the lesions, the invasion route of M, leprae to the peripheral nerve were also discussed. The significance of the appearence of the polpmorphoriuclear leucocytes and collagen fibrils in the lesions of active stage was also elucidated.