PATHOLOGY OF CHRONIC MYELOPATHY ASSOCIATED WITH HTLV-I INFECTION (HAM TSP)
PATHOLOGY OF CHRONIC MYELOPATHY ASSOCIATED WITH HTLV-I INFECTION (HAM TSP)
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DOI：
10.1016/0022-510x(90)90060-z
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发表时间：
1990-04-01
影响因子：
4.4
通讯作者：
IWASAKI, Y
中科院分区：
文献类型：
--
作者：
IWASAKI, Y
回顾了10例血清学证实为HTLV-1感染的日本HAM/TSP患者尸检的CNS病理学。基本的组织病理学特征是慢性进行性炎症过程，淋巴细胞和单核细胞显著的实质渗出进入脊髓的灰质和白色物质，在神经症状发作后持续3年以上，导致白色物质严重变性，伴有显著的胶质-间充质组织反应。炎症和白色变性在下胸髓最为明显。侧柱总是受到最严重的影响。虽然实质组织变性并不局限于任何特定的长束，对称变性的外侧锥体束是明显的，在所有情况下。在前柱也可见弥漫性髓鞘苍白，但通常是轻度的。后柱常受累，但白色变性的严重程度和范围各不相同。神经元保存相对较好。日本HAM/TSP的这些组织病理学特征与以前在热带地区描述的HAM/TSP基本一致。在炎症部位缺乏可检测量的HTLV-I抗原的情况下，“慢性进行性副生殖性肌萎缩”似乎是HAM/TSP这种独特组织病理学的最合适的描述性术语。
The CNS pathology of 10 autopsy cases of Japanese HAM/TSP patients with a serological confirmation of HTLV-I infection was reviewed. The essential histopathological feature was a chronic progressive inflammatory process with marked parenchymal exudation of lymphocytes and monocytes into both the grey and white matter of the spinal cord, uniquely perpetuating for more than 3 years after the onset of neurological symptoms, and resulting in severe degeneration of the white matter accompanied by marked glio-mesenchymal tissue reactions. both the inflammation and the white matter degeneration were most conspicuous in the lower thoracic cord. The lateral column was always and most severely affected. Although the parenchymal tissue degeneration was not confined to any particular long tracts, symmetrical degeneration of the lateral pyramidal tract was evident in all cases. Diffuse myelin pallor was also seen in the anterior column but it was usually mild. The posterior column was commonly involved but the severity and extent of the white matter degeneration were variable. Neurons were relatively well preserved. These histopathological features of HAM/TSP in Japan largely agree with those previously described for HAM/TSP in tropical regions. In the absence of detectable amount of HTLV-I antigens at the sites of inflammation, "chronic progressive parainfectious myelitis" seems to be the most appropriate descriptive term for this unique histopathology of HAM/TSP.