Ouyang Jie, Guzman Miguel, Desoto-Lapaix Fidelina, Pincus Matthew R, Wieczorek Rosemary
Department of Pathology, State University of New York Downstate Medical Center, and New York Harbor Healthcare System, Brooklyn, NY 11209, USA.
Int J Clin Exp Pathol. 2009 Sep 20;3(1):98-105.
Detection of early acute myocardial ischemia/infarction prior to neutrophilic infiltration in autopsy myocardium poses a diagnostic dilemma to the surgical pathologist. Morphological changes can be subtle or not identified at all on the hematoxylin and eosin stain. To evaluate the Masson's trichrome stain and immunohistochemical stains, desmin and myoglobin, in detecting acute myocardial ischemia/infarction in autopsy myocardium. We reviewed the autopsy files of the New York Harbor Healthcare System and retrieved 25 cases of early acute myocardial infarction. Three autopsy hearts of non-cardiac related deaths were used as controls. Sections from grossly suspected early acute myocardial infaction areas were stained by a Masson's trichrome stain technique and with desmin by a standard immnunohistochemical method. The ischemic zone surrounding myocardial infarction and the acute infarct itself in 23/25(92%) were detected by desmin depletion, and in all cases with Masson's trichrome color changes. No change in staining for desmin or Masson's trichrome were seen in the three controls. Desmin and Masson's trichrome together are valuable tools when faced with the problem of postmortem detection of early myocardial infarction/ischemia.
在尸检心肌中，在中性粒细胞浸润之前检测早期急性心肌缺血/梗死给外科病理学家带来了诊断难题。苏木精和伊红染色上的形态学变化可能很细微或根本无法识别。为了评估马松三色染色法和免疫组织化学染色法（结蛋白和肌红蛋白）在尸检心肌中检测急性心肌缺血/梗死的效果。我们查阅了纽约港医疗系统的尸检档案，检索出25例早期急性心肌梗死病例。选取3例非心脏相关死亡的尸检心脏作为对照。对大体上怀疑为早期急性心肌梗死区域的切片采用马松三色染色技术染色，并用标准免疫组织化学方法检测结蛋白。23/25（92%）的心肌梗死周围缺血区和急性梗死本身通过结蛋白缺失检测到，所有病例马松三色染色均有颜色变化。3例对照中结蛋白染色或马松三色染色均无变化。当面临早期心肌梗死/缺血的死后检测问题时，结蛋白和马松三色染色法共同构成了有价值的工具。
