Conlon M R, Chapman W B, Burt W L, Larocque B J, Hearn S A
Department of Ophthalmology, St. Joseph's Health Care Center, University of Western Ontario, London, Canada.
Ophthalmology. 1991 Oct;98(10):1556-9. doi: 10.1016/s0161-6420(91)32088-8.
Primary localized amyloidosis causing bilateral lacrimal enlargement is rare. The pathogenesis of amyloid deposition within the orbit and other body tissues has not been fully elucidated. The authors report the case of a 72-year-old woman who presented with bilateral lacrimal gland enlargement secondary to amyloid infiltration. The chemical nature of the deposit was characterized using light microscopy, immunohistochemistry, and immunoelectron microscopy. The primary (immunocytic) nature of the amyloid was confirmed by immunohistochemistry demonstrating the presence of monoclonal lambda light chains in the amyloid deposits and in the plasma cells. Using immunoelectron microscopy, amyloid deposits were seen containing lambda light chains in macrophages. It has been postulated that the macrophage has a role in amyloid deposition. The authors believe this to be the first published report of immunoelectron microscopy use in orbital amyloidosis, and that this technique has helped further their understanding of the nature and pathogenesis of this condition.
原发性局限性淀粉样变性导致双侧泪腺肿大较为罕见。淀粉样物质在眼眶及其他身体组织内沉积的发病机制尚未完全阐明。作者报告了一例72岁女性患者，其因淀粉样物质浸润继发双侧泪腺肿大。通过光学显微镜、免疫组织化学和免疫电子显微镜对沉积物的化学性质进行了表征。免疫组织化学证实淀粉样物质的原发性（免疫细胞性）本质，显示淀粉样沉积物和浆细胞中存在单克隆λ轻链。使用免疫电子显微镜观察到巨噬细胞中含有λ轻链的淀粉样沉积物。据推测，巨噬细胞在淀粉样物质沉积中起作用。作者认为这是首次发表的关于免疫电子显微镜在眼眶淀粉样变性中应用的报告，并且该技术有助于进一步加深他们对这种疾病的性质和发病机制的理解。
