Eckert H, Zaumseil I, Sehrt I
Z Erkr Atmungsorgane. 1977 Jul;149(1):94-5.
Correlative studies concerning the value of modern of morphological methods in correlation to the clinical picture were undertaken in patients with sarcoidosis. The investigations comprised immunopathological and histochemical studies of mediastinal lymph nodes, normal lymph nodes and lymphnodes by inflammatory lung diseases. The metabolic state of the granulomas in sarcoidosis is expressed by enzymehistochemical investigations and shows a strong activity of enzymes of the pentose cycle, cancer cycle, anaerobic glycolysis, respiratory chain and of hydrolytic enzymes. Of special interest is the activity of aminopeptidase in the granulomas, found only positive in progressive stage of the disease. With the aid of some hydrolases (acid phosphatase, nonspecific esterase) information is given about phagocytotic activity in granulomas. Antibody formation (anti-human-IgG, -IgA and -IgM) is visible in fresh cases around granulomas in the cytoplasms of large lymphoid cells, in some cases also in the walls of vessels. With longer duration of the disease immunoglobulins were found extracellulary first in little focal areas and later as a dense homogen material around the granulomas. In long existing cases only a weak or negative fluorescence was observed in this material, expressed by light microscopy as hyaline transformation. The value of this methods is given in additional information concerning the metabolic activity (especially phagozytosis) and immunological state (antibody formation) of the disease as an important factor for a well-timed and effective therapy.
对结节病患者进行了关于现代形态学方法的价值与临床表现相关性的研究。调查包括对纵隔淋巴结、正常淋巴结以及炎性肺疾病患者的淋巴结进行免疫病理学和组织化学研究。结节病中肉芽肿的代谢状态通过酶组织化学研究来表达，显示戊糖循环、糖酵解循环、无氧糖酵解、呼吸链和水解酶的酶活性很强。特别值得关注的是肉芽肿中氨肽酶的活性，仅在疾病进展期呈阳性。借助一些水解酶（酸性磷酸酶、非特异性酯酶）可了解肉芽肿中的吞噬活性。在新鲜病例中，在大淋巴细胞的细胞质中，肉芽肿周围可见抗体形成（抗人IgG、IgA和IgM），在某些情况下血管壁中也可见。随着疾病病程延长，免疫球蛋白首先在小的局灶区域细胞外被发现，随后在肉芽肿周围形成致密的均质物质。在病程较长的病例中，在这种物质中仅观察到微弱或阴性荧光，在光学显微镜下表现为透明变性。这些方法的价值在于提供了有关疾病代谢活性（尤其是吞噬作用）和免疫状态（抗体形成）的额外信息，这是及时有效治疗的重要因素。
