Delgado W A, Mosqueda A
Department of General Pathology, Teaching Hospital, Universidad Peruana Cayetano Heredia, Lima, Perú.
J Oral Pathol Med. 1989 May;18(5):310-4. doi: 10.1111/j.1600-0714.1989.tb00403.x.
Both labial salivary gland and gingival biopsies were taken from 19 patients with clinical findings suggestive of secondary amyloidosis. Amyloid deposits were present in all salivary gland biopsies (19/19) while amyloid deposits in gingiva were observed only in three cases (16%). No amyloid was found in similar biopsies from 11 control patients. Periductal amyloid involvement was found along the basement membrane in all salivary gland samples; additionally, 16 cases had periacinar infiltration (84%), 13 had perivascular (68%) and 7 (37%) showed interstitial deposits. Amyloid in gingiva was seen along the epithelial basement membrane, as in salivary glands, although in isolated areas and scattered at the top of some dermal papillae and small blood vessels. In secondary amyloidosis it therefore appears that amyloid is deposited along the epithelial basement membrane before perivascular deposition occurs. This study presents a new highly sensitive and reliable method for the diagnosis of secondary amyloidosis, a method which is technically simple, free from complications and well-accepted by the patients.
对19例有继发性淀粉样变性临床症状的患者进行了唇唾液腺和牙龈活检。所有唾液腺活检标本（19/19）均有淀粉样沉积，而牙龈淀粉样沉积仅在3例（16%）中观察到。11例对照患者的类似活检标本中未发现淀粉样物质。在所有唾液腺样本中，沿基底膜发现导管周围淀粉样物质浸润；此外，16例（84%）有腺泡周围浸润，13例（68%）有血管周围浸润，7例（37%）有间质沉积。牙龈中的淀粉样物质与唾液腺一样，见于上皮基底膜，不过是在孤立区域，散在于一些真皮乳头顶部和小血管处。因此，在继发性淀粉样变性中，似乎淀粉样物质在上皮基底膜沉积后才发生血管周围沉积。本研究提出了一种诊断继发性淀粉样变性的新的高灵敏度且可靠的方法，该方法技术简单，无并发症，患者易于接受。
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