蕈样肉芽肿（蕈样霉菌病）的病理构型分析

目的探讨蕈样肉芽肿（亦称蕈样霉菌病MycosisFungdes，MF）的病理组织学结构特点，寻找MF的诊断和早期诊断指标。方法低倍视野下扫视观察组织学的大体结构形式和病理变化规律。结果MF有4种基本病理构型：（1）真皮浅层淋巴细胞的带状苔癣样浸润；（2）淋巴细胞的向表皮性浸润；（3）真表皮交界面结构模糊不清和表皮内海绵水肿形成；（4）表皮银屑病样增生。结论以上4种病理构型为MF的基本变化规律，如进一步在高倍视野下确认浸润的淋巴细胞有脑回状、鸡爪状或异型核，MF的诊断即可以成立。苔癣样浸润见于MF的斑块期或红斑期，为较早期阶段的病理改变，表皮银屑病样增生的程度往往与MF的发展阶段呈正比。早期的MF必需与滴状副银屑病进行鉴别，但有人认为大斑块型副银屑病与MF有其内在的联系，尚有待进一步研究证实。

An Analysis of Pathological Configuration of Mycosis Fungoides

Objective TO explore the histopathological configuration and diagnostic criteria for mycosis fungoides. Methods Under light microscope, tissue sections (HE - staining) were scanned to look for the histopathological configuration in low power fields. Results In 12 cases of mycosis fungoides, four types of histopathological configuration were observed: (1) the infiltra- ation Of lymphocytes was lichenoid and band - shaped at dermopillary layer; (2) the lymphocyte infiltration tended towards cutic- ular layer; (3) the structre was not clear at dermoepidermal junction, and spongiform edema was seen in cuticular layer; (4) there was Psoriasis - like proliferation in the epidermis. Conclusions The above four types the basic Pathological changes of the mycosis fungoides.If the lymphocytes with nuclei convoluted or chicken claw in shape or of allotype are found in the high pow-er field, the diagnosis of mycosis fungoides can be definite. The lichenoid infiltration is the manifestation in the early starly of the mycosis. The degree of psoriasis - like epidermal Proliferation is positively Proportional to the course of the mycosis fungoides. In the early stage of mycosis fungoides, it should be differentiated from guttate carefully, and it is considered that the large Plaque type of parapsoriasis has interhal association with mycosis fungoides, that needs needs further study.