Histochemical and immunohistochemical differential diagnosis of amyloidosis -: a brief illustrated essay and personal experience with Romhanyi's method
Histochemical and immunohistochemical differential diagnosis of amyloidosis -: a brief illustrated essay and personal experience with Romhanyi's method
复制标题
DOI：
10.3109/13506120009146836
复制
发表时间：
2000-09-01
期刊：
影响因子：
--
通讯作者：
Apáthy, A
中科院分区：
文献类型：
--
作者：
Bély, M;Apáthy, A
介绍了转诊中心外科病理学中淀粉样变性的组织化学和免疫组织化学鉴别诊断。考虑不同形式的淀粉样变性，例如淀粉样变性。全身性广泛性淀粉样变性：继发性（AA）、原发性（AL）、老年性、血液透析相关性、遗传性和器官（组织）限制性（局部性）淀粉样变性：脑性、营养不良性（年龄相关，所谓“老年性”）、内分泌相关性、局部性、局灶性（集中分泌）和孤立性浆细胞（孤立性浆细胞瘤、B细胞）恶液质相关淀粉样变性。在 20°C 下预处理 1、3、5、10、15、20 或 25 秒，并通过胰蛋白酶消化在 20°C 下进行 5、10 或 30 秒、1、2、3、4、5、6 或 10 分钟氧化诱导蛋白水解，并根据Romhanyi，并通过链霉亲和素-生物素复合物/辣根过氧化物酶免疫组织化学反应证实。对淀粉样蛋白沉积物预处理的“敏感性”或“抗性”取决于淀粉样蛋白的类型和预处理的时间长度。次级（AA）淀粉样蛋白对KMnO4氧化敏感，随后胰蛋白酶消化（1分钟），其在偏振光下的绿色双折射消失，而初级（AL）（1-5分钟）、老年（1-10分钟）和大多数形式的器官（组织）限制（局部）淀粉样蛋白（1-10分钟）具有抗性。执行预处理后是明显的刚果嗜好。继发性 (AA) 对预处理（1 秒）敏感，而原发性 (AL) 淀粉样蛋白（1-20 秒）、老年性淀粉样蛋白（1-25 秒）和大多数形式的器官（组织）限制（局部、孤立）淀粉样蛋白沉积物（1-25 秒）具有抵抗力，并且始终呈正双折射。淀粉样蛋白沉积物的早期识别和分化对于预后和治疗选择很重要。作者得出的结论是，所提出的经典组织化学方法可作为淀粉样变性组织学鉴定的一线筛选。
The histochemical and immunohistochemical differential diagnosis of amyloidosis in surgical pathology in a referral center is presented. Different forms of amyloidosis are considered e.g. systemic generalized amyloidosis: secondary (AA), primary (AL), senile, hemodialysis-associated, hereditary and organ (tissue)-limited (localized) amyloidosis: cerebral, dystrophic (age-related, so-called "senile"), endocrine-related, localized to rumours, focal (concentrated secretion), and isolated plasma cell (solitary plasmacytoma, B-cell) dyscrasia related amyloidosis. The amyloid deposits were identified and characterized histochemically by Congo red staining after performate pre-treatment at 20 degrees C for 1,3,5,10,15,20 or 25 sec, and with oxidation induced proteolysis by trypsin digestion at 20 degrees C for 5, 10, or 30 sec, 1,2,3,4,5,6 or 10 min and covered with gum-arabic according to Romhanyi, and confirmed by streptavidin-biotin-complex/horseradish peroxidase immunohistochemical reactions. The "sensitivity" or "resistance" to pre-treatment of amyloid deposits depends on the type of amyloid, and the length of pre-treatment. Secondary (AA) amyloid is sensitive to KMnO4 oxidation, followed by trypsin digestion (for 1 min), and its green birefringence under polarized light disappears, while primary (AL) (for 1-5 min), senile (for 1-10 min), and most forms of organ (tissue)-limited (localized) amyloid (for 1-10 min) are resistant. Performate pretreatment is followed by pronounced congophilia. Secondary (AA) is sensitive to performate pre-treatment (for 1 sec), while primary (AL) amyloid (for 1-20 sec), senile (for 1-25 sec), and most forms of organ (tissue)-limited (localized, isolated) amyloid deposits (for 1-25 sec) are resistant, and are constantly positively birefringent. Early identification and differentiation of amyloid deposits is important for the prognosis and for the choice of therapy. The authors conclude that the presented classical histochemical methods are useful as first line screens for the histological identification of amyloidosis.