Nakajima M, Niki Y, Manabe T, Matsushima T
Department of Medicine, Kawasaki Medical School, Kurashiki, Japan.
Kansenshogaku Zasshi. 1996 Sep;70(9):963-9. doi: 10.11150/kansenshogakuzasshi1970.70.963.
The usefulness of the serial section method was investigated in four bone marrow aspirates, four biopsies and nine autopsy specimens obtained from patients with miliary tuberculosis who were admitted to our hospital between 1974 and 1994. In original sections, granulomas consistent with tuberculosis were found in two out of four aspirate specimens (50%) but in none of the four bone marrow biopsies. By using serially out sections, however, granulomas were detected in two more aspirate specimens and two biopsies which were negative in original sections. Consequently four of four aspirates (100%) and two of four biopsies ((50%) became positive. In addition, the distribution of granulomas was investigated using vertebral bone marrows obtained from 12 autopsy cases. We divided the vertebral bone marrows obtained from 12 autopsy cases. We divided the vertebra into the peripheral and central portions. Granulomas were more frequently found in the peripheral portions than in the central. The higher detection rate of granulomas in the peripheral bone marrow when the biopsy and aspiration needles easily reach, suggests that bone marrow aspiration and/or biopsy would be a useful procedure for the diagnosis miliary tuberculosis. Therefore if serial sections were utilized for such samples in the miliary tuberculosis patients, the detection rate is expected to became much higher.
我们对1974年至1994年间收治的粟粒性肺结核患者的4份骨髓穿刺物、4份活检标本和9份尸检标本进行了连续切片法的实用性研究。在原始切片中，4份穿刺标本中有2份（50%）发现了符合结核病的肉芽肿，但4份骨髓活检标本均未发现。然而，通过使用连续外切片，在另外2份原始切片为阴性的穿刺标本和2份活检标本中检测到了肉芽肿。因此，4份穿刺标本中的4份（100%）和4份活检标本中的2份（50%）呈阳性。此外，我们使用12例尸检病例的椎骨骨髓研究了肉芽肿的分布。我们将12例尸检病例的椎骨骨髓进行了划分。我们将椎体分为外周和中央部分。外周部分比中央部分更频繁地发现肉芽肿。当活检和穿刺针容易到达时，外周骨髓中肉芽肿的检出率较高，这表明骨髓穿刺和/或活检对于粟粒性肺结核的诊断将是一种有用的方法。因此，如果对粟粒性肺结核患者的此类样本采用连续切片，预计检出率会更高得多。
