Westermark P, Stenkvist B, Natvig J B, Olding-Stenkvist E
Ann Rheum Dis. 1979 Feb;38(1):68-71. doi: 10.1136/ard.38.1.68.
Polarisation microscopy of material obtained by fine needle biopsy of subcutaneous tissue and stained with Congo red is a simple and reliable method for the diagnosis of systemic amyloidosis. It cannot, however, be used to differentiate histologically between different forms of amyloidosis. In the present study extracts of material obtained by fine needle biopsy of subcutaneous fat tissue from 13 patients were examined by double immunodiffusion with an antiserum against protein AA, a unique protein which forms a major part of the fibrils in secondary amyloidosis. Five of the patients showed amyloid deposits round the fat cells by conventional microscopy. In 3 of these, all with rheumatoid arthritis, protein AA was detected. Eight patients without amyloidosis and 2 with myelomatosis and amyloidosis showed no reaction with antiprotein AA antiserum. Thus the material obtained by fine needle biopsy of subcutaneous tissue could be used not only for the histological diagnosis of amyloidosis but also for a classification of systemic amyloidosis into secondary or primary based on the type of amyloid fibril protein involved.
对经皮下组织细针穿刺活检获取并经刚果红染色的材料进行偏振显微镜检查，是诊断系统性淀粉样变的一种简单可靠的方法。然而，它不能用于在组织学上区分不同形式的淀粉样变。在本研究中，用抗AA蛋白的抗血清通过双向免疫扩散法检测了13例患者经皮下脂肪组织细针穿刺活检获取的材料提取物，AA蛋白是一种独特的蛋白质，在继发性淀粉样变中构成原纤维的主要部分。5例患者通过传统显微镜检查显示脂肪细胞周围有淀粉样沉积物。其中3例均患有类风湿性关节炎，检测到了AA蛋白。8例无淀粉样变的患者以及2例患有骨髓瘤和淀粉样变的患者与抗AA蛋白抗血清无反应。因此，经皮下组织细针穿刺活检获取的材料不仅可用于淀粉样变的组织学诊断，还可根据所涉及的淀粉样原纤维蛋白类型将系统性淀粉样变分为继发性或原发性。
