Chimelli L, Nascimento O, Freitas M R
Departamento de Patologia, Universidade Federal Fluminense, Niterói, Brasil.
Arq Neuropsiquiatr. 1989 Dec;47(4):413-22. doi: 10.1590/s0004-282x1989000400006.
Peripheral nerve biopsies when processed with conventional techniques for paraffin embedding usually do not provide sufficient data for the diagnostic conclusion. However, if the nerve is processed for resin embedding for semi and ultra-thin sections and teasing of fibres, several aspects can be analysed including quantitative and morphometric data. We studied the sural nerve biopsy of 78 patients examined at the Antonio Pedro University Hospital, Niterói RJ, applying those techniques and we found that in 55 cases (70.5%) the pathologic diagnosis was conclusive, in 11 (14.1%) although the nerve had abnormalities it was not possible to establish a diagnosis, and in 12 (15.4%) the nerve was normal. In 68 cases there was a clinical diagnosis which was confirmed in 49 but not in the remaining 19, since 8 had non-specific changes and 11 were normal. From the 10 cases which did not have a clinical diagnosis the biopsy was conclusive in 6, showed non-specific changes in 4, and was normal in 1 case. The pathologic conclusion in most of our cases was possible because not only we had the clinical data but all the nerves were processed for resin embedding.
采用常规石蜡包埋技术处理周围神经活检组织时,通常无法提供足够的数据用于得出诊断结论。然而,如果将神经组织进行树脂包埋以制作半薄和超薄切片并进行纤维分离,就可以分析多个方面,包括定量和形态测量数据。我们对在里约热内卢州尼泰罗伊市安东尼奥·佩德罗大学医院接受检查的78例患者的腓肠神经活检组织应用了这些技术,发现55例(70.5%)病例的病理诊断是明确的,11例(14.1%)虽然神经存在异常但无法做出诊断,12例(15.4%)神经正常。68例有临床诊断,其中49例得到了证实,其余19例未得到证实,因为8例有非特异性改变,11例正常。在没有临床诊断的10例病例中,活检结果6例明确,4例显示非特异性改变,1例正常。在我们的大多数病例中能够得出病理结论,是因为我们不仅有临床数据,而且所有神经组织都进行了树脂包埋处理。