Boldorini R, Tosoni A, Mazzucco G, Cernuschi M, Caramello P, Maran E, Costanzi G, Monga G
Dipartimento di Scienze Mediche, Facoltà di Medicina e Chirurgia di Novara, Italy.
Pathol Res Pract. 1996 Mar;192(3):249-59. doi: 10.1016/S0344-0338(96)80228-7.
Small intestinal biopsies of 21 patients with acquired immunodeficiency syndrome (AIDS) with light microscopic findings diagnostic or suspicious for parasite infection were investigated by transmission electron microscopy (TEM). TEM allowed us to identify and specify the genus and species of involved parasites in 16 out of the 21 cases: 7 Cryptosporidium parvum, 5 Enterocytozoon bieneusi and 4 Isospora belli. Cryptosporidium was easily identified on light microscopy (LM), and only slightly influenced by parasite burden in all the 7 cases; TEM confirmed LM diagnosis and made it possible to characterize the parasites as C. parvum. The identification of Microsporidium on LM in our cases was related to the burden of parasite; its presence was certainty identified in 2 cases and suspected in 3. TEM allowed to identify these parasites as E. bieneusi. Intracytoplasmic coccidia could be detected with certainly in semithin sections in all 4 cases, but TEM was always needed to specify the infectious agent as I. belli. In 5 cases the suspicious of protozoan infection on LM (3 microsporidia, 1 intracytoplasmic coccidia and 1 Cryptosporidium) was not confirmed by TEM. Our data suggest that TEM is an appropriate diagnostic tool in this field of pathology and necessary in most of the cases.
对21例获得性免疫缺陷综合征（AIDS）患者的小肠活检标本进行了研究，这些标本在光学显微镜下的检查结果可诊断或怀疑有寄生虫感染，采用透射电子显微镜（TEM）进行观察。TEM使我们能够在21例中的16例中识别并确定所涉及寄生虫的属和种：7例微小隐孢子虫、5例比氏肠胞微孢子虫和4例贝氏等孢球虫。隐孢子虫在光学显微镜（LM）下很容易识别，在所有7例中仅受寄生虫负荷的轻微影响；TEM证实了LM诊断，并使将寄生虫鉴定为微小隐孢子虫成为可能。在我们的病例中，光学显微镜下微孢子虫的识别与寄生虫负荷有关；在2例中确定存在，在3例中怀疑存在。TEM使我们能够将这些寄生虫鉴定为比氏肠胞微孢子虫。在所有4例中，在半薄切片中都能肯定地检测到胞质内球虫，但始终需要TEM来将感染因子确定为贝氏等孢球虫。在5例中，光学显微镜下对原生动物感染的怀疑（3例微孢子虫、1例胞质内球虫和1例隐孢子虫）未得到TEM的证实。我们的数据表明，TEM是该病理学领域合适的诊断工具，在大多数情况下是必要的。
