Crain B J, McPhatter L, Croom D W, Hulette C M
Department of Pathology, Duke University Medical Center, Durham, NC 27710.
Acta Neuropathol. 1995;89(1):42-9. doi: 10.1007/BF00294258.
We recently examined the brain from an 8-month-old infant with Down's syndrome and found argyrophilic plaque-like deposits throughout the neocortex and cerebellum. To ascertain the specificity of this observation, we examined 27 additional brains from the pediatric autopsy service, including 1 from another patient with Down's syndrome. To our surprise, similar argyrophilic deposits were found in 16 of these cases. The deposits were equally well stained by three different silver stains and had the same size, shape, and distribution in gray matter as the diffuse amyloid plaques commonly seen in adults. However these structures appeared to be amyloid negative. There were no obvious differences in the primary diagnoses amongst the group of patients with argyrophilic deposits and the group without them, and the origin, permanence, and functional significance of these plaque-like deposits are still unknown. Nonetheless, their recognition is important since they may represent subtle brain injury and since similar structures in adults might easily be misinterpreted as true diffuse amyloid plaques.
我们最近检查了一名患有唐氏综合征的8个月大婴儿的大脑，发现整个新皮层和小脑中存在嗜银斑块样沉积物。为了确定这一观察结果的特异性，我们检查了儿科尸检服务提供的另外27个大脑，其中包括另一名唐氏综合征患者的大脑。令我们惊讶的是，在其中16个病例中发现了类似的嗜银沉积物。这些沉积物用三种不同的银染法染色效果同样良好，并且在灰质中的大小、形状和分布与成年人常见的弥漫性淀粉样斑块相同。然而，这些结构似乎对淀粉样蛋白呈阴性反应。有嗜银沉积物的患者组和没有嗜银沉积物的患者组在主要诊断方面没有明显差异，这些斑块样沉积物的起源、持久性和功能意义仍然未知。尽管如此，对它们的识别很重要，因为它们可能代表轻微的脑损伤，而且成年人中的类似结构很容易被误判为真正的弥漫性淀粉样斑块。
