Orfila C, Giraud P, Modesto A, Suc J M
Hum Pathol. 1986 Apr;17(4):366-9. doi: 10.1016/s0046-8177(86)80459-2.
Abdominal fat tissue aspirates from 12 patients with biopsy-proved amyloidosis were investigated by different morphologic techniques. By light microscopy, after staining of the fat tissue aspirates with Congo red and examination with a polarizing microscope, positive results were obtained in nine patients with amyloidosis, two of the three with primary (AL) amyloidosis and seven of the nine with secondary (AA) amyloidosis. By indirect immunofluorescence, using AA antiserum, positive results were obtained in five of the nine cases of AA amyloidosis (aspirates from these five patients were positive on Congo red staining). By electron microscopy, amyloid fibrils were observed in five cases of amyloidosis (two of the AL and three of the AA type, all positive on Congo red staining). Although amyloid was demonstrated less frequently by immunofluorescence and electron microscopy, perhaps because of the small numbers of fat particles examined, it seems that, with Congo red staining, abdominal fat tissue aspiration is a simple and sensitive method for the diagnosis of amyloidosis. Immunofluorescence studies allow discrimination between the different types of amyloidosis. The method could be used in patients in whom other types of tissue biopsy are not recommended because of risks of bleeding or other problems.
采用不同形态学技术对12例经活检证实为淀粉样变性患者的腹部脂肪组织抽吸物进行了研究。通过光学显微镜，用刚果红对脂肪组织抽吸物进行染色并在偏振显微镜下检查，9例淀粉样变性患者得到阳性结果，其中3例原发性（AL）淀粉样变性患者中有2例，9例继发性（AA）淀粉样变性患者中有7例。通过间接免疫荧光法，使用AA抗血清，9例AA淀粉样变性病例中有5例得到阳性结果（这5例患者的抽吸物刚果红染色呈阳性）。通过电子显微镜检查，在5例淀粉样变性病例中观察到淀粉样纤维（2例AL型和3例AA型，均刚果红染色呈阳性）。尽管免疫荧光法和电子显微镜检查显示淀粉样物质的频率较低，可能是因为检查的脂肪颗粒数量较少，但似乎通过刚果红染色，腹部脂肪组织抽吸术是诊断淀粉样变性的一种简单而敏感的方法。免疫荧光研究有助于区分不同类型的淀粉样变性。该方法可用于因出血风险或其他问题而不建议进行其他类型组织活检的患者。
