Huang Juan, Dai Lin, Lei Song, Liao Dian-ying, Wang Xiao-qing, Luo Tian-you, Chen Yu, Hang Zhen-biao, Li Gan-di, Dong Dan-dan, Xu Gang, Gu Zheng-ce, Hao Ji-ling, Hua Ping, He Lei, Duan Fang-lei
Department of Pathology, West China Hospital, Sichuan University, Chengdu 610041, China.
Zhonghua Bing Li Xue Za Zhi. 2010 Apr;39(4):225-9.
To evaluate the diagnostic utility of Warthin-Starry silver stain, immunohistochemistry and transmission electron microscopy in the detection of human Bartonella henselae infection and pathologic diagnosis of cat scratch disease (CSD).
The paraffin-embedded lymph node tissues of 77 histologically-defined cases of cat scratch disease collected during the period from January, 1998 to December, 2008 were retrieved and studied using Warthin-Starry silver stain (WS stain) and mouse monoclonal antibody against Bartonella henselae (BhmAB stain). Five cases rich in bacteria were selected for transmission electron microscopy.
Under electron microscope, the organisms Bartonella henselae appeared polymorphic, round, elliptical, short rod or bacilliform shapes, ranged from 0.489 to 1.110 microm by 0.333 to 0.534 microm and often clustered together. Black short rod-shaped bacilli arranged in chains or clumps were demonstrated in 61.0% (47/77) of CSD by WS stain. The organisms were located outside the cells and lie mainly in the necrotic debris, especially near the nodal capsule. In 72.7% (56/77) of the cases, dot-like, granular as well as few linear positive signals were observed using BhmAB immunostain and showed similar localization. Positive results for both stains were identified in 59.7% (46/77) of the cases. When applying both stains together, Bartonella henselae was observed in 74.0% (57/77) of the case. The difference between the results obtained by WS stain and BhmAB immunostain was of statistical significance (P < 0.05).
Bartonella henselae is the causative pathogen of cat scratch disease. WS stain, BhmAB immunostain and transmission electron microscopy are helpful in confirming the histologic diagnosis. Immunostaining using BhmAB can be a better alternative than WS stain in demonstrating the organisms.
评估Warthin-Starry银染色、免疫组织化学及透射电子显微镜检查在检测人汉赛巴尔通体感染及猫抓病（CSD）病理诊断中的应用价值。
检索1998年1月至2008年12月期间收集的77例经组织学确诊的猫抓病石蜡包埋淋巴结组织，采用Warthin-Starry银染色（WS染色）及抗汉赛巴尔通体小鼠单克隆抗体（BhmAB染色）进行研究。选取5例细菌丰富的病例进行透射电子显微镜检查。
在电子显微镜下，汉赛巴尔通体呈多形性，圆形、椭圆形、短杆状或杆状，大小为0.489至1.110微米×0.333至0.534微米，常聚集在一起。WS染色显示，61.0%（47/77）的CSD病例中有呈链状或团块状排列的黑色短杆状杆菌。这些微生物位于细胞外，主要存在于坏死碎片中，尤其是在淋巴结被膜附近。72.7%（56/77）的病例中，使用BhmAB免疫染色观察到点状、颗粒状以及少量线性阳性信号，并显示出相似的定位。59.7%（46/77）的病例中两种染色均呈阳性结果。同时应用两种染色时，74.0%（57/77）的病例中观察到汉赛巴尔通体。WS染色和BhmAB免疫染色结果之间的差异具有统计学意义（P < 0.05）。
汉赛巴尔通体是猫抓病的致病病原体。WS染色、BhmAB免疫染色及透射电子显微镜检查有助于确诊组织学诊断。在显示微生物方面，使用BhmAB进行免疫染色可能是比WS染色更好的选择
