Giorgadze Tamar A, Shiina Natsuko, Baloch Zubair W, Tomaszewski John E, Gupta Prabodh K
Department of Pathology and Laboratory Medicine, Cytopathology and Cytometry Section, University of Pennsylvania Medical Center, Philadelphia, Pennsylvania, USA.
Diagn Cytopathol. 2004 Nov;31(5):300-6. doi: 10.1002/dc.20131.
Amyloid fat pad aspiration specimens for cases with a clinical suspicion of amyloid typically are stained with Congo red and examined by brightfield microscopy. Congophilia with apple-green birefringence by polarization microscopy (PM) is considered diagnostic for amyloid. Examination of Congo red-stained slides by fluorescent microscopy (FM) is considered by some to be a more sensitive detection method. In this study, we assessed the utility of this technique in cytopathology archival slides from abdominal fat pad aspirations previously stained with Congo red dye. Seventy-eight cases of abdominal fat pad aspirations collected during the last 5 yr and stained with the Congo red procedure were obtained from archival files. Additionally, 20 adipose tissue material slides prepared from the surgical pathology specimens were examined as controls. One representative smear was examined in each case using FM equipped with rhodamine excitation/absorption (540/570 nm) filters. Relevant clinical information was obtained in all cases. Twelve cases (15.4%) of the 78 fat pad aspiration cases were reported originally as positive by Congo red stain using polarization and apple-green birefringence as diagnostic criteria. On review, four cases were deemed unsatisfactory. By FM examination 29 of the 74 (39.2%) cases were reclassified as positive for amyloid. The results were confirmed by immunohistochemical stain for amyloid P protein and electron microscopy. A number of similar distinct fluorescence and immunohistochemical patterns were recognized in the positive cases. Minimally weak fluorescence in the adipose tissue was observed in the control cases. The use of FM in Congo red-stained fat pad smears can improve the detection of amyloid in cytology preparations.
对于临床怀疑为淀粉样变的病例，淀粉样脂肪垫穿刺标本通常用刚果红染色，并通过明场显微镜检查。偏振显微镜（PM）下呈现苹果绿色双折射的嗜刚果红性被认为是淀粉样变的诊断依据。一些人认为，通过荧光显微镜（FM）检查刚果红染色玻片是一种更灵敏的检测方法。在本研究中，我们评估了该技术在先前已用刚果红染料染色的腹部脂肪垫穿刺细胞病理学存档玻片上的应用价值。从存档文件中获取了过去5年收集的78例腹部脂肪垫穿刺标本，这些标本均采用刚果红染色法染色。此外，还检查了20张从手术病理标本制备的脂肪组织材料玻片作为对照。在每例中，使用配备罗丹明激发/吸收（540/570 nm）滤光片的FM检查一张代表性涂片。所有病例均获取了相关临床信息。在78例脂肪垫穿刺病例中，最初有12例（15.4%）根据偏振和苹果绿色双折射作为诊断标准，刚果红染色报告为阳性。复查时，4例被判定为不合格。通过FM检查，74例中的29例（39.2%）重新分类为淀粉样变阳性。结果通过淀粉样P蛋白免疫组化染色和电子显微镜得到证实。在阳性病例中识别出了一些相似的独特荧光和免疫组化模式。在对照病例中，脂肪组织中观察到极微弱的荧光。在刚果红染色的脂肪垫涂片中使用FM可以提高细胞学制剂中淀粉样变的检测率。
