Miura K, Fukuda H, Mineta H, Yamaguchi K, Harada H, Yusa H, Tsutsui Y
Division of Pathology, Hamamatsu University School of Medicine, Japan.
Pathol Int. 2000 Dec;50(12):992-8. doi: 10.1046/j.1440-1827.2000.01138.x.
An extremely rare phosphoglyceride deposition disease is reported. A healthy 62-year-old Japanese woman suffered from tumors that repeatedly appeared in injured soft tissues for more than 20 years. No immunologic disorders or abnormal laboratory data were found. Histology showed foreign body granulomas consisting of macrophages surrounding yellowish-white crystals. The crystals were weakly positive by von Kossa's method, were dissolved in 30% acetic acid with gas, and were easily dissolved in 0.1 N NaOH or potassium hydroxide, losing their crystal structure. Using a scanning electron microscopy X-ray microanalyzer, phosphorus and calcium peaks were detected. Phosphoglycerides were detected by microscopic infrared spectrophotometry and microsampling mass spectrometry. The gold hydroxamic acid method for detecting phosphoglyceride showed strong positive staining in the crystals. Based on the above analyses, the deposited crystals were regarded as phosphoglyceride, which bound calcium as a counter ion. The crystals tended to be deposited at sites of injury, where macrophages had accumulated. The patient had received many injections of a medicine made from alcohol extract from bovine liver. We suspect that this medicine was related to the cause of the deposition as the deposition repeatedly appeared at the site of the injections.
报告了一种极为罕见的磷酸甘油酯沉积病。一名62岁健康的日本女性患有肿瘤，这些肿瘤在受伤的软组织中反复出现长达20多年。未发现免疫紊乱或实验室数据异常。组织学检查显示异物肉芽肿，由围绕黄白色晶体的巨噬细胞组成。这些晶体用冯·科萨法呈弱阳性，可在30%乙酸中溶解并产生气体，且易溶于0.1 N氢氧化钠或氢氧化钾，失去晶体结构。使用扫描电子显微镜X射线微分析仪检测到磷和钙峰。通过显微红外分光光度法和微量采样质谱法检测到了磷酸甘油酯。检测磷酸甘油酯的金异羟肟酸法在晶体中显示出强阳性染色。基于上述分析，沉积的晶体被认为是磷酸甘油酯，它以钙离子作为抗衡离子结合。晶体倾向于沉积在巨噬细胞聚集的损伤部位。该患者曾多次注射由牛肝酒精提取物制成的药物。我们怀疑这种药物与沉积的病因有关，因为沉积反复出现在注射部位。
