Histological and immunohistochemical features suggesting aetiological differences in lymph node and (muco)cutaneous feline tuberculosis lesions.
Histological and immunohistochemical features suggesting aetiological differences in lymph node and (muco)cutaneous feline tuberculosis lesions.
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DOI：
10.1111/jsap.13386
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发表时间：
2021-06
期刊：
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通讯作者：
J. L. Mitchell;J. Del Pozo;C. Woolley;R. Dheendsa;J. Hope;D. Gunn-Moore
中科院分区：
文献类型：
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作者：
J. L. Mitchell;J. Del Pozo;C. Woolley;R. Dheendsa;J. Hope;D. Gunn-Moore
目的：鉴别和描述在诊断病理环境中可能区分与牛分枝杆菌和微分枝杆菌相关的皮肤和淋巴结病变的组织学和免疫组织化学标准。材料与方法对存档的结核性病变皮肤和淋巴结活检组织进行苏木精和伊红染色，Ziehl-Neelsen和Masson三色染色。免疫组化检测calprotectin、CD3、Pax5的表达。对样本进行组织学参数评分（即伴有中心坏死的肉芽肿与无中心坏死的小肉芽肿、坏死和/或多核巨细胞的百分比）、抗酸杆菌数量（细菌指数）、纤维化病变百分比和免疫组化染色阳性。结果共检出22份样品（牛分枝杆菌11例，微分枝杆菌11例）。在控制年龄、性别和组织的情况下，猫牛分枝杆菌相关病变更常表现为伴有中央坏死的大多层肉芽肿。相反，这种表现在猫微分枝杆菌相关病变中并不常见，主要是无中心坏死的小肉芽肿。外纤维囊的存在在两组中是不同的，细菌指数也是不同的。两组间病变内免疫组织化学标志物表达差异无统计学意义。在调查这些病例时，皮肤和淋巴结病变组织学外观的差异可能有助于在早期阶段推断猫感染了牛支原体或微支原体，从而使临床医生了解潜在的人畜共患风险。重要的是，肺结核病例可以出现大量的抗酸杆菌。这意味着高细菌指数并不意味着感染了非人畜共患的非结核分枝杆菌。
OBJECTIVES To identify and describe histological and immunohistochemical criteria that may differentiate between skin and lymph node lesions associated with Mycobacterium (M.) bovis and M. microti in a diagnostic pathology setting. MATERIALS AND METHODS Archived skin and lymph node biopsies of tuberculous lesions were stained with haematoxylin and eosin, Ziehl-Neelsen and Masson's Trichrome. Immunohistochemistry was performed to detect the expression of calprotectin, CD3 and Pax5. Samples were scored for histological parameters (i.e. granulomas with central necrosis versus small granulomas without central necrosis, percentage necrosis and/or multinucleated giant cells), number of acid-fast bacilli (bacterial index) and lesion percentage of fibrosis and positive immunohistochemical staining. RESULTS Twenty-two samples were examined (M. bovis n=11, M. microti n=11). When controlling for age, gender and tissue, feline M. bovis-associated lesions more often featured large multi-layered granulomas with central necrosis. Conversely, this presentation was infrequent in feline M. microti-associated lesions, where small granulomas without central necrosis predominated. The presence of an outer fibrous capsule was variable in both groups, as was the bacterial index. There were no differences in intralesional expression of immunohistochemical markers. CLINICAL SIGNIFICANCE Differences in the histological appearance of skin and lymph node lesions may help to infer feline infection with either M. bovis or M. microti at an earlier stage when investigating these cases, informing clinicians of the potential zoonotic risk. Importantly, cases of tuberculosis can present with numerous acid-fast bacilli. This implies that a high bacterial index does not infer infection with non-zoonotic non-tuberculous mycobacteria.