大骨节病软骨坏死的组织学形态再观察

对16例尸检档案骨检材料就大骨节病（KBD）软坏死死，特别对软骨细胞坏死的组织学形态再做光镜观察，为该病病因研究寻找有用线索。结果发现，软骨细胞凝固性坏死可表现为在形态及其演化过程完全不同的A、B两型：A型坏死的细胞胞体常较大、轮廓略不清，胞质红染、内含空泡较多，胞核固缩、碎裂断而溶解消失，胞核从不红染；B型者胞体小、轮廓清，胞质内空泡少、中度红染，胞核增大、核内出现坏状体。软骨细胞B型凝固性坏死对KBD的病理改变可能有特异性，其坏死原因可能是某特异病毒感染，深层的软骨坏死可能是骨髓血细胞病变向软骨内扩散继发出现的。

Reexamination on Histomorphology of Chondronecrosis in Kaschin-Beck Disease

To look for some useful clue to the cause research of Kaschin-Beck disease (KBD), histomorphology of chondronecrosis, especially of chondrocytic necrosis in bone samples of 16 cases with KBD in our autopsy achives was reexamined with light microscopy. The chondrocytic coagulative necroses were shown as type-A and -B with fully different shapes and its development processes respectively. In the type-A, the body volume of necrotic chondrocyte was often larger and the outline was not clear slightly, the plasm contained more vacuoles and was stainned as red, the nuclei showed karyopyknosis, karyorrhexis and disappearance subsequently. Never was the nucleus stainned as red. In the type-B, the body volume of necrotic chondrocyte was smaller and the outline was clear, the plasm contained less vacuoles and stainned as middle-red, the nucleus enlarged, lilac-red dotted substances developed and associated with chromatin lysis in the nucleus until the nucleus transformed into larger and round mass with lightish brown and homogenization. Later, acidophilous spots developed within the mass and ring without the mass. The author discussed about the possibility that type-B coagulative necrosis of chondrocytes might be specific for the pathological changes of KBD, the necrotic cause may be some specific virus infection, and the chondronecroses at deep layers of cartilages might be secondarily caused by contact spreading from necrotic lesions of blood cells in bone marrows to cartilages.