Lin Ying-You, Hsiao Cheng-Hsiang, Hsu Yung-Hsiang, Lee Chin-Cheng, Tsai Hsiang-Jung, Pan Ming-Jeng
Graduate Institute of Veterinary Medicine, National Taiwan University, Taipei, Taiwan.
J Formos Med Assoc. 2006 Nov;105(11):911-7. doi: 10.1016/S0929-6646(09)60176-5.
BACKGROUND/PURPOSE: Bartonella henselaeis the causative agent of cat scratch disease (CSD), manifesting as fever and acute regional lymphadenopathy. Although serologic testing is the reference method for diagnosis, successful use of immunohistochemical (IHC) stain of regional lymph nodes for the diagnosis of CSD has been reported. To determine the characterization and diagnostic potential of IHC in lymphadenopathy of CSD, lymph nodes were excised from patients with suspected CSD for further evaluation.
Polyclonal antibody-based IHC studies were performed for the detection of B. henselae. Between January 2001 and December 2004, the reference laboratory of the Center for Disease Control, Taiwan, received a total of 377 sera from 352 reported suspected CSD cases. Twenty-three formalin-fixed paraffin-embedded lymph nodes from 16 patients and two skin biopsies from two patients suspected of having CSD were included in this study. Nine of them were serologically confirmed to have CSD and the others were seronegative but suspected to have CSD by the attending physicians. Seven lymph node specimens were obtained from tuberculosis patients for comparison.
We demonstrated that the microorganisms existed in the cytoplasm of histiocytes within the granulomatous lesions in nine lymph nodes and one skin biopsy. Among the nine lymph nodes with IHC (+) stains, three were seronegative. On the other hand, three cases were IHC (+) and six cases were IHC (-) among nine seronegative patients. In addition, two seronegative patients with skin biopsy showed one IHC (+) and one IHC (-).
IHC can contribute to the etiologic diagnosis of B. henselaelymphadenopathy when serology and molecular techniques are not available.
背景/目的：汉赛巴尔通体是猫抓病（CSD）的病原体，表现为发热和急性局部淋巴结病。虽然血清学检测是诊断的参考方法，但已有报道成功使用局部淋巴结的免疫组织化学（IHC）染色来诊断CSD。为了确定IHC在CSD淋巴结病中的特征和诊断潜力，从疑似CSD患者中切除淋巴结进行进一步评估。
进行基于多克隆抗体的IHC研究以检测汉赛巴尔通体。2001年1月至2004年12月，台湾疾病控制中心参考实验室共收到352例报告的疑似CSD病例的377份血清。本研究纳入了16例患者的23个福尔马林固定石蜡包埋淋巴结和2例疑似CSD患者的2份皮肤活检标本。其中9例经血清学确诊为CSD，其余为血清学阴性但主治医生怀疑患有CSD。从结核病患者中获取7个淋巴结标本进行比较。
我们证明，在9个淋巴结和1份皮肤活检标本的肉芽肿性病变的组织细胞胞质中存在微生物。在9个IHC（+）染色的淋巴结中，3个为血清学阴性。另一方面，9例血清学阴性患者中3例为IHC（+），6例为IHC（-）。此外，2例血清学阴性的皮肤活检患者中，1例为IHC（+），1例为IHC（-）。
当血清学和分子技术不可用时，IHC有助于汉赛巴尔通体淋巴结病的病因诊断。
