Chomette G, Auriol M, Habib K, Biaggi A
Service d'Anatomie pathologique, Hôpital de la Pitié, Paris.
Rev Stomatol Chir Maxillofac. 1992;93(1):54-7.
Diagnosis of amyloidosis depends on the demonstration of amyloid deposits in biopsies using specific stains. Recently, in addition to classical biopsies (kidney, liver, gum, skin, rectal mucosa), labial salivary gland biopsy has been recommended as safe diagnostic method. In our recruitment, it allowed the fortuitous discovery of amyloidosis in three patients suffering from rheumatoid polyarthritis or spondylarthritis. In five other patients (2 cases of familial amyloidosis, 1 dysglobulinemia, 2 primary cardiac amyloidosis), biopsy was performed for systematic search of amyloidosis. In five of these eight cases, a sicca syndrome was associated with the salivary deposits. These deposits were stained with congo red viewed in polarized light and with T thioflavine. Besides, Wright's method allowed to know the AL or AA type of amyloidosis and thus to guide the treatment. On the whole, labial salivary gland biopsy is a highly sensitive method for diagnosis of primary and secondary amyloidosis.
淀粉样变性的诊断取决于使用特定染色剂在活检组织中显示淀粉样沉积物。最近，除了经典活检（肾脏、肝脏、牙龈、皮肤、直肠黏膜）外，唇唾液腺活检已被推荐为一种安全的诊断方法。在我们的招募工作中，它偶然发现了3例类风湿性多关节炎或脊椎关节炎患者患有淀粉样变性。在另外5例患者中（2例家族性淀粉样变性、1例球蛋白异常血症、2例原发性心脏淀粉样变性），进行活检以系统筛查淀粉样变性。在这8例中的5例中，干燥综合征与唾液沉积物相关。这些沉积物用刚果红染色，在偏振光下观察并用硫黄素T染色。此外，瑞氏方法可以确定淀粉样变性的AL型或AA型，从而指导治疗。总体而言，唇唾液腺活检是诊断原发性和继发性淀粉样变性的一种高度敏感的方法。
