尖锐湿疣与假性湿疣组织病理和超微结构的鉴别研究

对６５例尖锐湿疣及２７例假性湿疣进行组织病理及超微结构观察。尖锐湿疣的组织病理特征为表皮角化过度伴角化不全，棘层肥厚，表皮突延长，表皮内散在或群集的空泡细胞，真皮乳头部毛细血管增生、扩张，其周围有淋巴细胞及组织细胞浸润；假性湿疣外型呈乳头瘤样突起，其粘膜上皮与正常粘膜相似，呈分布均匀、大小一致的空泡样，无异形性，粘膜上皮包绕的疏松结缔组织中毛细血管扩张。尖锐湿疣的超微结构特征为表皮各层细胞核增大、肿胀，有些增生的核中可见１～３个核内小体及染色质间颗粒和染色质周围颗粒；假性湿疣未见核内小体，亦未见染色质间颗粒和染色质周围颗粒，结缔组织中毛细血管扩张。以上不同点有助于尖锐湿疣与假性湿疣的鉴别诊断。

Study of Histopathological and Ultrastructural Differences between Condylomata Acuminata and Pseudocondyloma of Vulvae

Histopathological alterations of condylomata acuminata were characterized by hyperkeratosis,parakeratosis,acanthosis,elongation of the rete ridges, pseudoepitheliomatous hyperplasia,discrete or grouped koilocytes, proliferation and dilatation of dermal capillaries, lymphocytic and histocytic infiltration around dermal capillaries, Histopathological pattern of pseudocondyloma of vulvae were characterized by finger-shaped configuration,epithelium was similar to normal of mucous membrane without atypia, The lesion was composed of a rich vascular network surrounded by connective tissue and a mild lymphocytic infiltration,Ultrastructural alterations of condylomata acuminata were characterized by proliferation of basal cells, enlarged and swollen nuclei in all layers,1-4 large nucleoli,1-3 nuclear bodies,interchromatin granules and perichromatin granules in some proliferating nuclei,swollen mitochondria, dilatated endoplasmic reticulum, and dissolved glycogen. Ultrastructural alterations of pseudocondyloma of vulvae were characterized by proliferation of mucomembranous epithelial cells, mild swollen nuclei,1-2 nucleoli, no nuclear body interchromatin and perichromatin granule,the dilatation of interstitial capillaries, and abundant fibril bundles in the dermis.Thus,the histopathological and ultrastructural manifestations of condylomata acuminata and pseudocondyloma of vulvae were significantly different. It may be of help in differentiation between the two disease.