Neo-Suzuki Sakurako, Mineshige Takayuki, Kamiie Junichi, Kayanuma Hideki, Mochizuki Yukako, Hisasue Masaharu, Tsuchiya Ryo, Shirota Kinji
Laboratory of Small Animal Internal Medicine, School of Veterinary Medicine, Azabu University, Sagamihara, Japan.
Laboratory of Veterinary Pathology, School of Veterinary Medicine, Azabu University, Sagamihara, Japan.
Vet Clin Pathol. 2017 Jun;46(2):331-336. doi: 10.1111/vcp.12486. Epub 2017 May 18.
A 3-year-old, spayed female, Domestic Shorthair cat presented with anorexia, lethargy, vomiting, probable hemoabdomen, and multiple masses on the right lateral liver lobe. Clinicopathologic and imaging abnormalities included anemia, azotemia, icterus, and hepatomegaly with hypoechoic masses. On cytologic evaluation of a fine-needle aspiration of a liver mass there was abundant extracellular pink- to purple-colored material between hepatocytes. The amorphous material was stained with direct fast scarlet (DFS), and green birefringent areas were observed under polarized light, confirming the presence of amyloid. A unique finding on the cytologic smear were macrophages containing amorphous and fibrillar amyloid-like protein. Histopathologic examination using H&E and Congo red staining confirmed amyloid deposits within the space of Disse, along the sinusoids, portal tracts, blood vessel walls, and within the cytoplasm of macrophages. Immunohistochemical staining with anti-AA amyloid antibodies further confirmed the presence of AA amyloid. To the author's knowledge, this is the first report of the cytologic finding of AA amyloid protein within macrophages and DFS stain detection of amyloid on a cytologic smear.
一只3岁已绝育的雌性家养短毛猫，出现厌食、嗜睡、呕吐、疑似腹腔积血，右侧肝叶有多个肿块。临床病理和影像学异常包括贫血、氮质血症、黄疸和肝脏肿大伴低回声肿块。对肝脏肿块进行细针穿刺细胞学评估时，肝细胞之间有大量细胞外粉红色至紫色物质。该无定形物质用直接耐晒猩红（DFS）染色，在偏振光下观察到绿色双折射区域，证实存在淀粉样蛋白。细胞学涂片上一个独特的发现是含有无定形和纤维状淀粉样蛋白样蛋白的巨噬细胞。使用苏木精-伊红（H&E）和刚果红染色的组织病理学检查证实，狄氏间隙、沿窦状隙、门管区、血管壁以及巨噬细胞胞质内有淀粉样蛋白沉积。用抗AA淀粉样蛋白抗体进行免疫组织化学染色进一步证实了AA淀粉样蛋白的存在。据作者所知，这是关于巨噬细胞内AA淀粉样蛋白的细胞学发现以及细胞学涂片上淀粉样蛋白的DFS染色检测的首次报告。
