EB病毒感染相關(guān)性疾病

1、Straathof KC,Bollard CM,Rooney CM,et al.Immunotherapy for EBV associated cancers in children.Oncologist,2003,8(1):83-98A:T2加權(quán)頸髓、腦干、小腦、間腦、中腦、丘腦廣泛高信號B-D：壓水相和T1加權(quán)示腦干、小腦異常信號伴彌漫腦實(shí)質(zhì)對比度增強(qiáng)，主要見于軟腦膜。E-F：T2普通片和T1增強(qiáng)后，位于小腦、小腦蚓上表面的軟腦膜信號明顯增強(qiáng)。腦積水和腦室擴(kuò)大脈絡(luò)膜炎 * 早期噬血并不常見,與臨床嚴(yán)重程度不相平行,晚期陽性率高,故需多次多部位骨穿. 25%患者確診時可無噬血細(xì)胞.In t

2、he endoneurial space, many Macrophages are visibleOne macrophage is labeled bySilver granules, it is located inSchwann cell cytoplasm, which is labeled by gold particles. (MS normal myelin sheath )Severe rarefaction of nerve fibers. AMacrophage has penetrated a Schwann cell; the myelin sheaths arebe

3、ginning to be destroyed. A macrophage dissociates the Myelin sheath. Schwann-cell cytoplasm.A: 硬膜下滲出, 多處壞死(CT)B:大片高信號融合區(qū)(T2加權(quán))C:對稱性小腦白質(zhì)的壞死A: (MRI)T2 加權(quán)白質(zhì)局部高信號B: (MRI) 1年后同一患者白質(zhì)和皮質(zhì)萎縮(MRI) 小腦T1加權(quán), 小箭頭示軟腦膜增強(qiáng), 寬箭頭血管周圍間隙增強(qiáng)(淋巴)細(xì)胞及噬血細(xì)胞浸潤T2加權(quán)MRI, 小腦高密度(繼發(fā)脫髓鞘)口咽部EBV感染幼稚B細(xì)胞，表達(dá)全部潛伏蛋白（潛伏3型），由此使B細(xì)胞激活、增殖，并移動至淋巴濾泡形成生發(fā)中心。EBNA3和LP被下調(diào)，僅EBNA1和LMPs表達(dá)（潛伏2型）。LMPs表達(dá)使B細(xì)胞在生發(fā)中心的反應(yīng)中存活下來并成為靜止期記憶B細(xì)胞記憶B細(xì)胞進(jìn)入血循環(huán)，其它EBV蛋白的下調(diào)使EBV在B細(xì)胞中持續(xù)存在并逃避宿主免疫反應(yīng)，EBNA1在分裂的B細(xì)胞中周期性表達(dá)使病毒基因組被分配到每一個子細(xì)胞中（潛伏1型）當(dāng)B細(xì)胞再循環(huán)至口咽