Wullbrand A, Saeger W, Missmahl H P, Voigt C, Linke R P
Department of Pathology, Marienkrankenhaus Hamburg, Federal Republic of Germany.
Virchows Arch A Pathol Anat Histopathol. 1990;416(4):335-41. doi: 10.1007/BF01605294.
Intervertebral discs from 82 consecutive operations on herniation and 59 autopsies (one case with generalized amyloidosis) were studied. Amyloid deposits observed in surgical and autopsy specimens increased with age in both series. Degenerative changes were related to age and to amyloid deposits in autopsy, but not in surgical cases. Calcium pyrophosphate dihydrate deposits (often in proximity to amyloid deposits) were found in autopsy discs of six patients and in surgical specimens of three patients with previous operations on herniated discs. Antisera against amyloid fibril proteins of different types including AA-, A lambda-, A kappa, AF- and AB-types showed no reaction with disc amyloid. In one case with generalized A lambda-amyloidosis the disc amyloid was not of the A lambda-type. Based on our results, we suppose that disc amyloid is a form of localized senile amyloidosis - possibly representing a new class of amyloid limited to cartilage tissue.
对82例连续的椎间盘突出手术取出的椎间盘以及59例尸检(其中1例患有全身性淀粉样变性)的椎间盘进行了研究。在这两个系列中,手术和尸检标本中观察到的淀粉样沉积物均随年龄增加。尸检中,退变改变与年龄及淀粉样沉积物有关,但在手术病例中并非如此。在6例患者的尸检椎间盘以及3例曾接受椎间盘突出手术的患者的手术标本中发现了二水焦磷酸钙沉积物(常靠近淀粉样沉积物)。针对不同类型淀粉样原纤维蛋白(包括AA型、Aλ型、Ak型、AF型和AB型)的抗血清与椎间盘淀粉样物质无反应。在1例全身性Aλ淀粉样变性病例中,椎间盘淀粉样物质并非Aλ型。基于我们的研究结果,我们推测椎间盘淀粉样物质是一种局限性老年淀粉样变性——可能代表一种仅限于软骨组织的新型淀粉样物质。