CHARACTER AND PECULIARITIES OF MORPHOLOGICAL CHANGES IN PALATINE TONSILS IN PATIENTS WITH CHRONIC TONSILLITIS IN DEPENDENCE ON THE LEVEL OF APPOTHOSIS OF LYMPHOCYTES
DOI:
https://doi.org/10.11603/1811-2471.2017.v1.i3.8155Keywords:
tonsillitis, apoptosis, epithelium, metaplasia, sclerosis.Abstract
When comparing the state of apoptosis and necrosis in lymphocytes of palatine tonsils and peripheral blood by morphological researches results in patients with chronic tonsillitis established the dependence of morphological changes from the state of apoptosis.
The aim of the study. Set the level of apoptosis and its relation with necrosis in the lymphocytes and neutrophils of the palatine tonsils homogenate and in the peripheral blood of patients with chronic tonsillitis and to compare the obtained data with the results of morphological studies.
Material and methods. The examination of patients with chronic tonsillitis after tonsillectomy with the definition of the state of apoptosis and necrosis in lymphocytes and neutrophils of the homogenate of the palatine tonsils and in peripheral blood on flow cytofluorometer has been performed. In addition, all patients were given morphological examination of palatine tonsils removed.
Results of the research and their discussion. At chronic tonsillitis in lymphocytes apoptosis prevails over necrosis. This predominance is characteristic for bacterial damage of the tonsils, unlike the viral, where it is manifested in neutrophils. And the multiplicity of this predominance correlates with morphological changes in the tonsils itself. As the pathomorphological changes increase, multiplicity also increases ratio of apoptosis/necrosis. So, at a ratio of 2-3 times the pathomorphological picture is represented only by moderate vascular reactions in the form of increased vascularization with an increase in the number and enlargement of the lumen of small arteries and arterioles with simultaneous decrease bandwidth of arteries of medium caliber. This is along with the morphological state of the mucous membrane, connective tissue capsule and follicles gives reasons to believe that the disease is still in the stage of compensation and subject to conservative treatment. At a ratio of apoptosis/necrosis 4-6 were registered vascular changes of a divination nature. They were joined by morphological changes in the form of thickening of the mucous membrane, thickening of connective tissue capsule and decrease the size of the follicles and their enlightenment, which together with the phenomena of metaplasia and hyperkeratosis of the epithelium of the mucous membrane can be a confirmation of subcompensation of pathological the process. Detected with the multiplicity of the ratio of apoptosis/necrosis in 7 times and more morphological changes in the form of further degradation of the epithelium of the mucosa, proliferation of the connective tissue both in the capsule and its penetration into parenchyma with pronounced perivascular sclerosis, destructive changes with a macrophage reaction in considerably reduced in size lymphoid follicles, and the presence of clusters of protein detritus and the corresponding vascular reactions are the signs of decompensation of the disease and the need for its surgical treatment.
Conclusions. At a ratio of apoptosis/necrosis in lymphocytes of a homogenate of palatine tonsils and peripheral blood equal 2-4 the morphological changes in the tonsils themselves correspond to the disease in the stage of compensation, at a ratio of 4-6 according to morphological studies, the process can be considered as subcompensated and at a ratio of 7 and more - decompensated.
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