Torlakovic E, Clayton F, Ames E D
Department of Pathology, St. Luke's/Roosevelt Hospital, New York, New York 10019.
Am J Clin Pathol. 1992 Mar;97(3):318-21. doi: 10.1093/ajcp/97.3.318.
The appearance of mycobacteria was studied in Wright-stained bone marrow preparations of human immunodeficiency virus-infected patients and compared with acid-fast-stained trephine biopsy sections and culture results. Mycobacterium avium complex in Romanowsky-stained preparations may be seen as extracellular and intracellular clear or red refractile beaded rods and nonrefractile "negative images." Refractile mycobacteria were seen in 17 of 20 culture-positive cases. Acid-fast stain of the trephine biopsy demonstrated organisms in only 11 of the 20 cases. Thus, six cases were culture positive and contained refractile rods but had no acid-fast organisms on the trephine biopsy. No false-positive results were seen with Romanowsky stain; the three false-negative results for refractility also were negative with acid-fast stain. Examination of Romanowsky-stained smears or imprints for refractile mycobacteria provides a reliable and sensitive method to identify mycobacteria in this population. Romanowsky-stained bone marrow aspirate and imprint smears should be examined for refractile bacilli when mycobacterial infection is suspected.
对人类免疫缺陷病毒感染患者的瑞氏染色骨髓涂片进行分枝杆菌外观研究，并与抗酸染色的环钻活检切片及培养结果进行比较。在罗曼诺夫斯基染色涂片中，鸟分枝杆菌复合体可表现为细胞外和细胞内透明或红色折光性串珠状杆菌以及非折光性“阴性影像”。在20例培养阳性病例中，有17例可见折光性分枝杆菌。环钻活检的抗酸染色显示，20例病例中仅11例有菌。因此，有6例培养阳性且含有折光性杆菌，但环钻活检未见抗酸菌。罗曼诺夫斯基染色未出现假阳性结果；3例假阴性的折光性结果抗酸染色也为阴性。检查罗曼诺夫斯基染色涂片或印片以寻找折光性分枝杆菌，为识别该人群中的分枝杆菌提供了一种可靠且敏感的方法。当怀疑有分枝杆菌感染时，应检查罗曼诺夫斯基染色的骨髓穿刺液和印片涂片以寻找折光性杆菌。
