Hutchins Rae G, Breitschwerdt Edward B, Cullen John M, Bissett Sally A, Gookin Jody L
Department of Clinical Sciences, North Carolina State University, 1060 William Moore Drive, Raleigh, NC 27607, USA.
J Vet Diagn Invest. 2012 Sep;24(5):888-94. doi: 10.1177/1040638712453583. Epub 2012 Aug 1.
Canine granulomatous hepatitis is an uncommon morphologic diagnosis that has been associated with a variety of diseases, including a number of systemic infectious etiologies. Formalin-fixed, paraffin-embedded (FFPE) tissues are typically the only source of liver tissue remaining for additional testing for the presence of infectious disease within granulomas. It is unclear if the more common infectious culprits of granulomatous hepatitis can be identified from such specimens. The aim of the current study was to retrospectively investigate archival FFPE liver tissue from dogs with granulomatous hepatitis for the presence of infectious agents. Semiquantitative analysis of copper accumulation in liver specimens was also performed. Medical records were examined for recorded evidence of systemic infectious disease diagnosis. Formalin-fixed, paraffin-embedded liver was prospectively evaluated for infectious agents via differential staining techniques (n = 13), eubacterial fluorescent in situ hybridization (n = 11), and Bartonella polymerase chain reaction assays (n = 15). An infectious cause of granulomatous hepatitis was not identified within liver tissue from any dog using these diagnostic methodologies. Six out of 25 (24%) dogs were diagnosed with concurrent systemic or localized bacterial infections at the time of presentation. Nine out of 17 (53%) dogs had excessive hepatic copper accumulation when evaluated by a semiquantitative histologic grading scheme or quantitative copper analysis. As definitive infectious causes of granulomatous hepatitis were not identified within archival liver biopsy samples, it was concluded that investigation of infectious etiologies within FFPE liver specimens using these diagnostic approaches may be of low yield.
犬肉芽肿性肝炎是一种不常见的形态学诊断，与多种疾病相关，包括一些全身性感染病因。福尔马林固定、石蜡包埋（FFPE）组织通常是剩余肝脏组织的唯一来源，用于进一步检测肉芽肿内是否存在传染病原体。目前尚不清楚能否从这些标本中识别出肉芽肿性肝炎更常见的感染病原体。本研究的目的是回顾性调查患有肉芽肿性肝炎的犬的存档FFPE肝脏组织中是否存在感染因子。还对肝脏标本中的铜蓄积进行了半定量分析。检查病历以寻找全身性传染病诊断的记录证据。通过鉴别染色技术（n = 13）、真细菌荧光原位杂交（n = 11）和巴尔通体聚合酶链反应检测（n = 15），对福尔马林固定、石蜡包埋的肝脏进行前瞻性评估以寻找感染因子。使用这些诊断方法，在任何一只犬的肝脏组织中均未发现肉芽肿性肝炎的感染病因。25只犬中有6只（24%）在就诊时被诊断为同时患有全身性或局部细菌感染。通过半定量组织学分级方案或定量铜分析评估，17只犬中有9只（53%）肝脏铜蓄积过多。由于在存档的肝活检样本中未发现肉芽肿性肝炎的确切感染病因，因此得出结论，使用这些诊断方法对FFPE肝脏标本中的感染病因进行调查可能收获甚微。
