Hiruma S, Ohtsuka K, Satou T, Furuta T, Kimura M, Hashimoto S
Department of Second Pathology, Kinki University School of Medicine, Osaka-Sayama.
Rinsho Byori. 1998 Feb;46(2):168-75.
Biopsied skeletal muscles from patients with inflammatory myopathy (6 cases of polymyositis (PM), 2 cases of dermatomyositis (DM), 5 cases of collagen disease with polymyositis and a case of allergic granulomatous angitis) were examined by comparing immunostained infiltrated cells at perivascular, perimysial and the endomysial sites as well as examining the histochemical findings on serial frozen sections from cases examined by our laboratory over the past three years. CD68 was used for macrophage, L26 for B lymphocytes, CD4 and CD8 for T lymphocytes. Expression of HLA-ABC was examined for Class I antigen and HLA-DR for Class II antigen on the muscle fibers. Many macrophages and CD8-positive T lymphocytes had infiltrated the endomysium in PM. Many CD4-positive T lymphocytes and L26-positive B lymphocytes had infiltrated perivascular sites in DM. These results were almost the same as those in many other reports. HLA-ABC was positive on the muscle sarcolemma in all cases. However, the expression of HLA-DR was not identical in all cases. It is useful to determine the diagnosis and consider a pathogenesis of inflammatory muscle diseases to analyze the infiltrated cells and the site of infiltration even in case showing few of infiltrating cells and necrotic fibers.
对炎性肌病患者(6例多发性肌炎(PM)、2例皮肌炎(DM)、5例合并多发性肌炎的胶原病患者及1例变应性肉芽肿性血管炎患者)的活检骨骼肌进行检查,通过比较血管周围、肌束膜和肌内膜部位免疫染色浸润细胞,并检查过去三年来本实验室检测病例的系列冰冻切片的组织化学结果。用CD68标记巨噬细胞,L26标记B淋巴细胞,CD4和CD8标记T淋巴细胞。检测肌纤维上I类抗原HLA-ABC和II类抗原HLA-DR的表达。在PM中,许多巨噬细胞和CD8阳性T淋巴细胞浸润到肌内膜。在DM中,许多CD4阳性T淋巴细胞和L26阳性B淋巴细胞浸润到血管周围部位。这些结果与许多其他报告的结果几乎相同。所有病例的肌纤维膜上HLA-ABC均呈阳性。然而,并非所有病例中HLA-DR的表达都相同。即使在浸润细胞和坏死纤维较少的病例中,分析浸润细胞及其浸润部位对于确定炎性肌肉疾病的诊断和考虑其发病机制也是有用的。