Blumenfeld W, Wagar E, Hadley W K
Am J Clin Pathol. 1984 Jan;81(1):1-5. doi: 10.1093/ajcp/81.1.1.
The authors used a method that includes Giemsa-stained touch preparations of a lung biopsy and culture of the same biopsy for viruses and microorganisms. The yield of etiologic agent diagnoses by this cytologic method was compared with yield from a simultaneous biopsy processed by usual histologic methods and stained by hematoxylin and eosin, silver methenamine, and other stains as necessary. Fifty-nine transbronchial biopsies and eight open lung biopsies were processed on 38 male patients with the clinical and laboratory features of acquired immunodeficiency syndrome (AIDS) to determine the etiology of their pulmonary disease. Pneumocystis carinii pneumonia was diagnosed in 16 patients. When sufficient material was available, the Giemsa-stained touch preparation agreed with the histologic examination. The touch preparation specimens were cultured, and seven of the patients with Pneumocystis carinii also had cytomegalovirus (CMV). Six additional patients had pulmonary CMV infection without evidence of Pneumocystis carinii pneumonia. Mycobacterial and fungal infections also were identified in these six patients. Sixteen patients had no specific diagnosis. With adequate material, their method provides reliable results and diagnosis within two to three hours of Pneumocystis carinii. In addition, it conserves the amount of specimen required, since the same material can be used for culture.
作者采用了一种方法，该方法包括对肺活检组织进行吉姆萨染色涂片以及对同一活检组织进行病毒和微生物培养。将这种细胞学方法诊断病原体的阳性率与同时采用常规组织学方法处理、苏木精-伊红染色、必要时进行六胺银染色及其他染色的活检组织的阳性率进行比较。对38例具有获得性免疫缺陷综合征（AIDS）临床和实验室特征的男性患者进行了59次经支气管活检和8次开胸肺活检，以确定其肺部疾病的病因。16例患者被诊断为卡氏肺孢子虫肺炎。当有足够的材料时，吉姆萨染色涂片结果与组织学检查结果一致。对涂片标本进行培养，16例卡氏肺孢子虫肺炎患者中有7例同时感染了巨细胞病毒（CMV）。另外6例患者有肺部CMV感染，但无卡氏肺孢子虫肺炎证据。这6例患者还发现有分枝杆菌和真菌感染。16例患者未明确诊断。有足够材料时，他们的方法能在两到三小时内提供关于卡氏肺孢子虫的可靠结果和诊断。此外，由于同一材料可用于培养，该方法还能节省所需标本量。
