Brady J G, Schutze G E, Seibert R, Horn H V, Marks B, Parham D M
Department of Pathology, Slot 517, University of Arkansas for Health Sciences, Little Rock 72205, USA.
Pediatr Dev Pathol. 1998 Jul-Aug;1(4):309-13. doi: 10.1007/s100249900044.
Retrospective review comparing the modified Dieterle stain with standard acid-fast stains was performed on seven surgical pathology cases that contained culture-positive mycobacteria infections. Tissues examined comprised cervical and submandibular lymph nodes and soft tissues of the face and chest. Modified Dieterle staining was performed on paraffin-embedded tissue sections, and the results were compared with those of hematoxylineosin stains and auramine-rhodamines and carbolfuchsin acid-fast stains. The acid-fast stain showed organisms in three of seven cases on initial review and five of seven cases on retrospective review; the auramine-rhodamine stain retrospectively revealed organisms in five cases. In contrast, the Dieterle stain showed organisms in all seven sections on retrospective examination. Dieterle stains revealed either beaded bacilli or nocardia-like filamentous organisms, sometimes with abundant granular debris possibly representing degenerative organisms. In three cases in which bacteria were readily apparent with the Dieterle stain, only rare organisms could be identified with the acid-fast stain. The modified Dieterle stain was more sensitive than the acid-fast stain in the identification of mycobacteria in pediatric specimens, and its use is recommended in cases with necrotizing granulomas. However, its specificity is limited by morphologic similarities of the organisms to those of nocardiosis and cat scratch disease.
对7例培养阳性的分枝杆菌感染的外科病理病例进行了回顾性研究，比较改良的迪特尔勒染色与标准抗酸染色。检查的组织包括颈部和下颌下淋巴结以及面部和胸部的软组织。对石蜡包埋的组织切片进行改良迪特尔勒染色，并将结果与苏木精-伊红染色、金胺-罗丹明染色和石炭酸复红抗酸染色的结果进行比较。抗酸染色在初次检查时7例中有3例显示有微生物，回顾性检查时7例中有5例显示有微生物；金胺-罗丹明染色回顾性显示5例中有微生物。相比之下，迪特尔勒染色在回顾性检查时7个切片中均显示有微生物。迪特尔勒染色显示为串珠状杆菌或诺卡菌样丝状微生物，有时伴有大量颗粒状碎片，可能代表退化的微生物。在3例迪特尔勒染色很容易观察到细菌的病例中，抗酸染色仅能识别出罕见的微生物。改良的迪特尔勒染色在儿科标本中分枝杆菌的鉴定方面比抗酸染色更敏感，建议在有坏死性肉芽肿的病例中使用。然而，其特异性受到该微生物与诺卡菌病和猫抓病微生物形态相似性的限制。
