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是非常重要的疾病的早期诊断。HIV感染者的口腔表现为肌萎缩、细菌或病毒感染、肿瘤或不明原因。口腔毛状白斑病的特点是在舌头的外侧边缘的白色斑块，不能擦去。光镜检查表明，病变的特点是角化不全，棘层，挖空细胞和缺乏炎症的上皮下组织。使用电子显微镜，疱疹病毒组（EB病毒; EBV）的颗粒被发现在上三分之二的上皮在这个病变。在棘层中，细胞核中密集地聚集着具有穿孔外观的浓缩染色质和处于不同组装阶段的EBV衣壳。口腔毛状白斑是HIV感染的早期征象，其重要性与83%的患者在确诊后31个月内发生AIDS（主要是卡氏肺膀胱炎肺炎）有关。口内卡波西肉瘤的电子显微镜研究显示，在扁平病变中，增生的内皮细胞突入血管腔。外生性病变由细长的梭形肿瘤细胞和裂缝状血管样管腔组成。梭形肿瘤细胞的特征是细胞内连接和韦伯-帕拉德体。口腔念珠菌病的电镜观察显示鳞状上皮上有许多白色念珠菌的线状真菌。

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.