Bohle R M, Heidemann A, Borkhardt A, Velcovsky H G, Altmannsberger H M
Institut für Pathologie, Universität Giessen.
Verh Dtsch Ges Pathol. 1994;78:189-94.
Standard techniques for the detection of mycobacteria in granulomatous diseases can be inadequate. We analysed 71 formalin fixed and paraffin-embedded tissue blocks from 68 non-immunocompromised patients with caseating, non-caseating, scarred, and miliary granulomas of lung and lymph nodes. A reamplification PCR protocol was established to detect a 123 bp product of the repetitive insertion sequence IS986/IS6110. After exclusion of 6 PCR-negative cases with clinical sarcoidosis 97% of lung tissue blocks with more than 10% caseating and non-caseating granulomas contained mycobacterial DNA. By routine microbiology mycobacteria could be detected in 78% of the patients. Scarred granulomas were PCR-negative. All miliary granulomas were PCR-positive. Lymph nodes showed comparable results. We think that this method facilitates aetiologic analysis of granulomatous diseases especially when the suspicous tissue is fixed and microbiology is not available.
检测肉芽肿性疾病中分枝杆菌的标准技术可能并不充分。我们分析了来自68例非免疫功能低下患者的71个福尔马林固定石蜡包埋组织块,这些患者患有肺部和淋巴结的干酪样、非干酪样、瘢痕样和粟粒性肉芽肿。建立了一种再扩增PCR方案,以检测重复插入序列IS986/IS6110的123 bp产物。排除6例临床结节病PCR阴性病例后,97%含有超过10%干酪样和非干酪样肉芽肿的肺组织块含有分枝杆菌DNA。通过常规微生物学方法,78%的患者可检测到分枝杆菌。瘢痕样肉芽肿PCR阴性。所有粟粒性肉芽肿PCR阳性。淋巴结显示出类似结果。我们认为,这种方法有助于肉芽肿性疾病的病因分析,特别是当可疑组织已固定且无法进行微生物学检测时。