Electron microscopic study on oral manifestations of human immunodeficiency virus infection

艾滋病毒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真菌、细菌或病毒感染、肿瘤或原因不明。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。在电子显微镜下，在病变的上三分之二的上皮中发现了疱疹病毒组(EB病毒；EBV)的颗粒。在棘层，核内密集排列着成团的突起的染色质和不同组装阶段的EBV衣壳。口腔毛状白斑是HIV感染的早期征象，其重要性与艾滋病(主要是卡氏肺囊炎肺炎)的发生有关，83%的患者在确诊后31个月内发病。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内连接和韦贝尔-帕拉德小体为特征。口腔念珠菌病的电子显微镜观察显示，鳞状上皮上有许多白色念珠菌穿透线状真菌。

Oral manifestations in HIV infection are numerous and some of these have been acknowledged as being of great importance in early diagnosis of the disease. Oral manifestations in HIV-infected individuals occured as mycotic, bacterial or viral infection, neoplasm or unknown etiology. Oral hairly 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 ; EBV) were found in the upper two thirds of the epithelium in this lesion. In the stratum spinosum, clumps of condensed chromatin with a punched-out appearance and EBV capsids in different stages of assembly were densely packed in the nucleus. Oral hairy leukoplakiais an early sign of HIV infection and its importance relates to the develop-ment of AIDS (mostly Pneumocystitis carinii pneumonia) in 83% of the affectedpatients 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 flat lesions. Exophytic lesions consisted of elongated spindle tumor cells and cleft-shaped, vessel-like lumina. Spindle tumor cells were characterized by intracellular junctions and Weibell-Palade bodies. Electron microscopic study on oral candidiasis showed many penetrating thread-like fungae of Candida albicans over the squamous epithelium.