Pérez V, García Marín J F, Badiola J J
Departamento de Patología Animal, Universidad de Zaragoza, Spain.
J Comp Pathol. 1996 Feb;114(2):107-122. doi: 10.1016/s0021-9975(96)80001-6.
Paratuberculosis lesions in naturally infected sheep were classified histologically. Adult sheep (n = 166) culled for various reasons, from four flocks in which clinical cases of the disease had occurred, were studied. Eight-two sheep (49.4%) showed lesions that could be divided into three main categories. Type 1 lesions, found in 24.1% of these animals, consisted of small granulomata formed by macrophages and were located exclusively in the ileocaecal Peyer's patch. In type 2 lesions, found in 4.8% of the sheep, granulomata were also observed in the mucosa associated with Peyer's patches. Type 3 lesions were characterized by granulomata in areas of the mucosa associated with, and also distinct from, the Peyer's patches. Three subtypes of type 3 lesions were recognized. In subtype 3a, found in 4.2% of the sheep, multifocal granulomata appeared in different areas of the lamina propria; they were not apparently associated with lymphoid tissue, and neither did they modify the morphology of the affected areas. Subtype 3b, found in 13.9% of animals, consisted of large numbers of macrophages, widespread in the lamina propria; in subtype 3c (2.4% of sheep) lymphocytes were the main inflammatory cell, with some macrophages scattered amongst them. In subtypes 3a and b, villi were distended and the mucosa appeared thickened. Mycobacteria could be demonstrated in tissue sections from all the samples with subtype 3b lesions and in almost all of those with type 2 and 3a lesions; these organisms were absent or sparse, however, in type 1 and 3c lesions. Macroscopical lesions were clearly visible only in sheep with type 3b and 3c lesions. Mycobacterium paratuberculosis was cultured from all the animals with type 3 lesions, from 87.5% of those with type 2 lesions, and from 47.5% of those with type 1. Type 3b lesions resembled the "borderline-lepromatous" form of mycobacterial lesions, whereas type 3c lesions resembled the "borderline-tuberculoid" form. The relationship between intestinal lymphoid tissue and paratuberculosis lesions is discussed, and the diagnostic importance of histological examination of the ileocaecal valve emphasized.
对自然感染绵羊的副结核病病变进行了组织学分类。研究了从四个发生过该病临床病例的羊群中因各种原因被扑杀的成年绵羊（n = 166）。82只绵羊（49.4%）出现了可分为三大类的病变。在这些动物中，24.1%出现了1型病变，由巨噬细胞形成的小肉芽肿组成，仅位于回盲部派伊尔氏淋巴集结。在4.8%的绵羊中发现了2型病变，在与派伊尔氏淋巴集结相关的黏膜中也观察到了肉芽肿。3型病变的特征是在与派伊尔氏淋巴集结相关以及与之不同的黏膜区域出现肉芽肿。识别出了3型病变的三个亚型。在4.2%的绵羊中发现的3a亚型，在固有层的不同区域出现多灶性肉芽肿；它们显然与淋巴组织无关，也未改变受影响区域的形态。在13.9%的动物中发现的3b亚型，由大量巨噬细胞组成，广泛分布于固有层；在3c亚型（2.4%的绵羊）中，淋巴细胞是主要的炎症细胞，其间散在一些巨噬细胞。在3a和3b亚型中，绒毛扩张，黏膜增厚。在所有有3b亚型病变的样本以及几乎所有有2型和3a型病变的组织切片中都能检测到分枝杆菌；然而，在1型和3c型病变中，这些微生物不存在或数量稀少。肉眼可见的病变仅在有3b和3c型病变的绵羊中明显。从所有有3型病变的动物、87.5%有2型病变的动物以及47.5%有1型病变的动物中培养出了副结核分枝杆菌。3b型病变类似于分枝杆菌病变的“边缘性瘤型”，而3c型病变类似于“边缘性结核样型”。讨论了肠道淋巴组织与副结核病病变之间的关系，并强调了回盲瓣组织学检查的诊断重要性。
