Electron microscopic study on oral manifestations of human immunodeficiency virus infection

HIV感染的口腔表现很多，其中一些已经被认为对疾病的早期诊断非常重要。HIV感染者的口腔表现为霉菌、细菌或病毒感染、肿瘤或原因不明。口腔念珠菌病应考虑为假膜型、增生型和红斑型。口腔毛状白斑的特点是舌侧缘有白色斑块，不能擦掉。光镜检查显示，病变的特点是角化不全、棘皮病、凹陷细胞增多，上皮下组织无炎症。口腔毛状白斑是HIV感染的早期征象，与艾滋病(主要是卡氏肺孢子虫肺炎)的发生有关，确诊后31个月内有83%的患者出现口腔毛白斑。口腔内Kaposi肉瘤的电子显微镜观察显示，在扁平的病变中，增殖的内皮细胞突入血管腔内。外生性病变由细长的梭形肿瘤细胞和裂隙状、血管样腔组成。梭形肿瘤细胞以细胞间连接和Webel-Palade小体为特征。

Oral manifestations in HIV infection are numerous and some of these have been acknowledged as bing of great importance in early diagnosis of the disease. Oral manifestations in HIV-infected individuals occurred as mycotic, bacterial or viral infection, neoplasm or unknown etiology. Oral candidiasis occurring as pseudomembranous, hyperplastic and erythematous types should be considered. Oral hairy leukoplakia is characterized by whitish plaques at the lateral border of the tongue which cannot be rubbed off. Light microscopic investigations indicated that the lesion is characterized by parakeratosis, acanthosis, koilocytosis and lack of inflammation in the subepithelial tissue. Using electron microscopy, particles of the herpes virus group(Epstein-Barr virus) were found in the upper two thirds of the epithelium in this lesion.Oral hairy leukoplakia is an early sign of HIV infection and its importance relates to the development of AIDS(mostly Pneumocystis carinii pneumonia) in 83% of the affected patients within 31 months after its diagnosis. Electron microscopic study on intraoral Kaposi's sarcoma showed proliferating endothelial cells protruded into the lumen of the vascular space in the flat lesions. Exophytic lesions consisted of elongated spindle tumor cells and cleft-shaped, vessel-like lumina. Spindle tumor cells were characterized by intercellular junctions and Weibel-Palade bodies.