SARS病例淋巴造血组织的病理形态与免疫表型

目的 探讨SARS病例淋巴造血组织病理及免疫表型变化。方法 对淋巴结、脾、结肠、小肠及骨髓组织行CD20、CD45RO(UCHL-1)、CD4、CD8、CD68、CD34标记和组织病理观察。结果 淋巴结、脾结构破坏，淋巴滤泡消失，脾小体萎缩，淋巴细胞明显减少，组织细胞增生；CD20淋巴结、脾B细胞弥漫散在阳性，CD45RO(UCHL-1)散在阳性，CD4T细胞显著减少，CD8T细胞稍增加，CD4／CD8比例明显小于0．5；结肠、小肠孤立和集合淋巴滤泡消失；骨髓增生减低，巨核细胞增多。结论 SARS对淋巴造血系统有明显损害，尤以T细胞为著，极似HIV感染的临床病理改变。

Pathological and immunohistochemical changes of lymphohemopoietic tissues in SARS

Objective To investigate the pathologic and immunophenotypic changes of lymphohemopoietic tissues in one case of severe acute respiratory syndrome (SARS). Methods Lymph nodes, spleen, small intestine, colon and bone marrow were studied by pathological and immunohistochemical techniques. The antibodies used included CD20, CD45RO (UCHL-1),CD4, CD8, CD68 and CD34. Results The structures of lymph nodes and spleen were damaged, in which lymph follicles depleted and splenic nodules atrophied. The specific changes included reduction of lymphocytes and hyperplasia of histiocytes. CD20 (+) B cells were widely spreaded in lymph nodes and spleen, and also CD45RO (UCHL-1)(+) T cells were scattered. Numbers of CD4 (+) help T cell rarely decreased, on the contrary, CD8(+) cytotoxic T cells increased, and CD4/CD8 ratio were no more than 0.5. Lymph follicles of small intestine and colon were depleted. Except that numbers of giant cells in the bone marrow increased, others reduced. Conclusion SARS evidently damaged lymphohemopioetic system, especially T cell. It was very similar to the pathological features of the human immunodeficiency virus infected lesions.