Nordborg E, Nordborg C
Dept of Rheumatology, Sahlgren's University Hospital, Göteborg, Sweden.
Clin Rheumatol. 1995 May;14(3):330-4. doi: 10.1007/BF02208349.
Temporal arterial biopsies from 27 patients with a clinical diagnosis of pure polymyalgia rheumatica (PMR) were examined using light microscopy on paraffin and plastic sections. The primary routine examination of the paraffin-embedded parts of the biopsies (biopsy length: 12.7 +/- 4.5 mm, sub-segments: 4.9 +/- 1.2 mm) revealed 4 positive cases, whereas the primary examination of the smaller plastic-embedded parts showed inflammation in 6 cases (biopsy length: 2.7 +/- 1.2 mm, sub-segments: 0.7 +/- 0.3 mm). Serial sectioning with a 50 microns interval of arteries which were negative primarily revealed three new positive cases in the paraffin-embedded material (total length: 174.0 mm), whereas sectioning the plastic-embedded material (total length: 52.8 mm) produced one more positive artery. All the new cases displayed a focal inflammatory process in atrophic, calcified arterial segments. The high yield of positive biopsies in the present material (11 of 27; 40.7%) demonstrates the diagnostic value of temporal arterial biopsy in PMR and the importance of a careful histologic examination. The results also indicate the influence of biopsy length on the yield of positive biopsies. The division of fixed temporal arterial biopsies into approximately 1-mm-long sub-segments before the embedding and the further serial sectioning of those negative biopsies which are atrophic and/or calcified is recommended in cases of pure PMR.
对27例临床诊断为单纯性风湿性多肌痛（PMR）患者的颞动脉活检标本，采用石蜡切片和塑料切片进行光学显微镜检查。对活检标本石蜡包埋部分（活检长度：12.7±4.5mm，子节段：4.9±1.2mm）的初步常规检查发现4例阳性病例，而对较小的塑料包埋部分的初步检查显示6例有炎症（活检长度：2.7±1.2mm，子节段：0.7±0.3mm）。对最初为阴性的动脉以50微米间隔进行连续切片，石蜡包埋材料中发现3例新的阳性病例（总长度：174.0mm），而对塑料包埋材料（总长度：52.8mm）切片又发现1例阳性动脉。所有新病例在萎缩、钙化的动脉节段均显示局灶性炎症过程。本材料中活检阳性率较高（27例中有11例；40.7%），证明颞动脉活检对PMR的诊断价值以及仔细组织学检查的重要性。结果还表明活检长度对活检阳性率的影响。对于单纯性PMR病例，建议在包埋前将固定的颞动脉活检标本切成约1毫米长的子节段，并对那些萎缩和/或钙化的阴性活检标本进行进一步连续切片。
