:A histologic study offour autopsy cases Hiroshi Takahashi and Haruo Okabe
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概要
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Sjögren's syndrome is now generally accepted to be a definite clinical entity with involvement of many organs, though little is known of its etiology. As an aid to clarification of its etiology, we attempted to describe histopathologically the arterial changes in the tongue and major salivary glands in four autopsy cases of Sjögren'ssyndrome; to point out the common arterialchanges; and to discuss some problems in the morphogenesis of the common arterial findings.<BR>All the patients were females. Their ages on first admission were 58, 36, 55, and 21 years, respectively.<BR>For histological examination, the arteries in the tongue and major salivary glands were classified by size and the diameter of the vessels was measured from the outer marign of the media. The classification of arteries is as follows. Large-sized arteries are more than 200μm indiameter; medium-sized arteries between100μm and200μm in diameter ; and small-sized arteries less than100μm in diameter. The caliber of the affected arteries in both the tongue and major salivary glands ranged from large-sized to small-sized arteries.<BR>We observed fresh and old arterial lesions of the tongue and major salivary glands in Sjögren's syndrome. Acute lesions included fibrinoid necrosis and vasculitis. Chronic lesions consisted of intimal fibrosis, medial hypertrophy, and periadventitial fibrosis. The most frequently occurring alteration of arteries was fibrinoid necrosis and intimal thickening. Although the caliber of arteries with fibrinoid necrosis and vasculitis in the tongue was found to range from small-sized to large-sized arteries, those in the major salivary glands were localized as medium-and small-sized arteries. Pathological change in the intimal thickening was composed of edematous and fibro-cellular thickening. The morphogenesis of intimal thickening suggests two pathogenic pathways:(1) organization of vasculitis;(2) response to increased blood flow or increased blood pressure.<BR>From these findings, it was suggested that the vascular changes in Sjjögren's syndrome are similar to those of periarteritis nodosa.
- 歯科基礎医学会の論文
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