Kommareddi S, Abramowsky C R, Swinehart G L, Hrabak L
Hum Pathol. 1984 Nov;15(11):1085-9. doi: 10.1016/s0046-8177(84)80253-1.
Nontuberculous (i.e., atypical) mycobacterial infections are increasing among pediatric and immunosuppressed patients, who commonly present with subcutaneous inflammatory masses or adenitis, which is often surgically excised. Since the most frequently isolated species also grow slowly in culture, early diagnosis may depend on histologic detection of a mycobacterial organism in the biopsy specimen. However, the histologic methods used for this purpose are of uncertain value in the diagnosis of these infections. Biopsy specimens from 22 patients with clinical histories highly consistent with nontuberculous mycobacteriosis in which part of the tissue was cultured were selected for study. Coded tissue blocks and control specimens were stained by the Ziehl-Neelsen (ZN) or auramine-O (A0) fluorescent technique and examined blindly for the presence of characteristic organisms. Results of these studies were compared with the culture results, and predictive values were calculated. This experience showed that the AO technique is technically simpler, allowing faster screening at lower power and showing greater sensitivity and predictive value of a negative result although less specificity than the ZN technique. The lower specificity of AO may be factitious and due to the detection in the tissue of organisms that did not grow in culture. Previous observations that nontuberculous mycobacterial infections may elicit tissue reactions that simulate cat-scratch disease, sarcoidosis, and nonspecific chronic inflammation were also confirmed.
非结核（即非典型）分枝杆菌感染在儿科患者和免疫抑制患者中呈上升趋势，这些患者通常表现为皮下炎性肿块或腺炎，常需手术切除。由于最常分离出的菌种在培养中生长也很缓慢，早期诊断可能依赖于活检标本中分枝杆菌生物体的组织学检测。然而，用于此目的的组织学方法在这些感染的诊断中价值不确定。选择了22例临床病史与非结核分枝杆菌病高度一致且部分组织进行培养的患者的活检标本进行研究。编码组织块和对照标本用萋-尼（ZN）或金胺-O（AO）荧光技术染色，并在盲法下检查是否存在特征性生物体。将这些研究结果与培养结果进行比较，并计算预测值。该经验表明，AO技术在技术上更简单，允许在低倍镜下更快地筛查，并且显示出更高的敏感性和阴性结果的预测值，尽管特异性低于ZN技术。AO较低的特异性可能是人为造成的，并且是由于在组织中检测到在培养中未生长的生物体。先前关于非结核分枝杆菌感染可能引发模拟猫抓病、结节病和非特异性慢性炎症的组织反应的观察结果也得到了证实。
