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目的观察结节病肉芽肿细胞内有无尘粒,分析尘粒的成分及其与结节病的相关性。方法收集50例结节病病理标本,用HE染色、Warthin-Starry(WS)银染色、免疫组化染色、透射电镜及X-线质谱元素分析等方法,以6例矽肺的尸检标本为对照,重点观察结节病和矽肺的肉芽肿的病理变化特点、其内有无尘粒及测定其主要元素成分。结果在结节病和矽肺病的肺内外肉芽肿类上皮细胞和多核巨细胞内均观察到以硅为主要元素的尘粒,结节病的尘粒数量少于矽肺；在结节病和矽肺病的肉芽肿内、胸膜和肺门淋巴结等处的淋巴管内均可见尘细胞；两种疾病的肉芽肿也有相同或相似之处。结论在结节病肉芽肿构成细胞内有数量较矽结节内为少的硅尘颗粒,提示此硅尘颗粒可能与结节病有关。
Objective To observe the presence or absence of dust particles in granulomatous cells of sarcoidosis and analyze the composition of dust particles and its relationship with sarcoidosis. Methods Fifty pathological specimens of sarcoidosis were collected. Six cases of silicosis were examined by HE staining, Warthin-Starry (WS) silver staining, immunohistochemistry, transmission electron microscopy and X-ray mass spectrometry. Focus on the observation of sarcoidosis and silicosis granuloma pathological changes, which have no dust particles and determine the main elements of the composition. Results In the sarcoidosis and silicosis, both granulomatous epithelial cells and multinucleated giant cells of the lung were observed with silicon as the main element of the dust particles, the number of sarcoidosis less than the number of silicosis; in sarcoidosis and silicosis Dysplasia granuloma, pleural and hilar lymph nodes and other lymphatic vessels are visible dust cells; two diseases of granulomas have the same or similarities. Conclusion The number of granuloma cells in the sarcoidosis granuloma is less than that in the silicon nodules, suggesting that the silica dust particles may be related to sarcoidosis.