A study on the tonsil with focal infections. With special referrence to the newly devised tonsillar cryptscope and the architecture of vessels in crypts.:WITH SPECIAL REFERRENCE TO THE NEWLY DEVISED TONSILLAR CRYPTSCOPE AND THE ARCHITECTURE OF VESSELS IN
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概要
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It is well known that inflamed human palatine tonsils have many surface crypts showing characteristic lymphoepithelial symbiosis, which play an important role in immune response. The cryptepithelia are rich in blood vessels. This proliferation of blood vessels is said to be the initiation of various kinds of immune responses. We devised a tonsillar cryptscope in order to observe the tonsillar crypt. Scopy with the cryptscope confirmed seven characteristic types of capillary vessels. The cryptscopic figures showed different patterns in tonsillar diseases such as hypertrophic tonsil, recurrent tonsillitis and tonsil with focal infection (palmoplantar pustulosis and psoriasis vulgaris). In this study the significances of tonsillar cryptscopic figures were investigated through the study of three dimensional structures of blood vessels and immuno-histology. In order to understand the structure of capillary vessels in details, human palatine tonsils were studied using corrosion casting techniques with a scanning electron microscope. Horseshoe type capillary vessels corresponded to the curved capillary vessels in the epithelium. This type of capillary vessel was observed in the epithelia covering the interfollicular area. The tonsillar blood vessels, along with closely related substances in the epithelium and the parenchyma, were immuno-histologically examined. Where the lymphocytes had densely infiltrated the epithelium, the basement membrane became thickened and often disrupted ; the endothelial cells were also enlarged. Adrian et al reported that lymphocytes invaded from the capillary vessels within the epithelia. Thus it was suggested that the horseshoe type was related to lymphocyte invasion of the epithelia. With the Arthus reaction in the rabbit tonsil, some resin leakage through the vessel walls around the crypt was observed in the three dimensional structure of capillary vessels. Immune complexes positive to anti-C3 and anti-IgG antibodies were found in the crypt epithelia of human tonsils with focal infection. The small bleeding spot was therefore attributed to the Arthus reaction. The tonsillar crypt scope is a useful instrument. It allows us to get information about various histological conditions of the cryptepithelia macroscopically without resort to tonsillectomy.
- 一般社団法人 日本耳鼻咽喉科学会の論文