Hunter S B, Ballinger W E, Rubin J J
Arch Pathol Lab Med. 1987 May;111(5):464-8.
Surgical biopsy specimens of multiple sclerosis plaques have been only infrequently reported, and the scanty descriptions of these specimens have generally emphasized the inflammatory nature of the lesion. We present surgical specimens from four patients with multiple sclerosis on whom biopsies were performed because of clinical features mimicking brain tumor. Both general pathologists and neuropathologists involved with these cases experienced difficulty in arriving at the correct diagnosis. In all four cases, the lesions were remarkably uniform in microscopic appearance, consisting of monotonous sheets of gemistocytic astroglia interspersed by numerous foamy macrophages. In sections stained with hematoxylin-eosin, the most helpful diagnostic features were the even distribution of the foamy macrophages and the absence of associated necrosis. In each case, the diagnosis was confirmed with special stains that disclosed total destruction of myelin sheaths with relative preservation of axons. Significant inflammatory infiltration was present in only one of five biopsy specimens.
多发性硬化斑块的手术活检标本报道甚少，对这些标本的简略描述通常强调病变的炎症性质。我们展示了4例多发性硬化患者的手术标本，这些患者因临床特征类似脑肿瘤而接受了活检。参与这些病例的普通病理学家和神经病理学家在做出正确诊断时均遇到困难。在所有4例病例中，病变的微观表现非常一致，由单调的肥胖型星形胶质细胞片层夹杂大量泡沫状巨噬细胞组成。在苏木精-伊红染色切片中，最有助于诊断的特征是泡沫状巨噬细胞分布均匀且无相关坏死。在每例病例中，通过特殊染色证实了诊断，特殊染色显示髓鞘完全破坏而轴突相对保留。5份活检标本中只有1份存在显著的炎症浸润。
