偏振光显微镜对诊断原发性气管支气管淀粉样变的价值并文献复习  

Siginifcance of polarizing microscope for the diagnosis of primary tracheobronchial amyloidosis and literature review

作　　者：应央央[1] 马德东[1] 肖伟[1] 

机构地区：[1]山东大学齐鲁医院呼吸内科,山东济南250012

出　　处：《山东大学学报（医学版）》2014年第4期67-69,共3页Journal of Shandong University:Health Sciences

摘　　要：目的探讨偏振光显微镜在诊断原发性气管支气管淀粉样变(PTBA)的价值,以减少误诊。方法在偏振光显微镜下观察13例刚果红阳性患者的病理切片,并对1987年以来国内公开发表的104例临床资料完整、病理结果确定的PTBA病例进行总结和分析。结果偏振光显微镜下13例刚果红染色阳性患者病理切片只有8例显示黄绿色双折光体。单纯以刚果红阳性作为诊断标准的假阳性率为39.5%,照此比例国内报道的104例病例中有近40例存在误诊可能。结论只有刚果红染色和偏振光显微镜观察均为阳性时,才能诊断PTBA。Objective To explore the application of polarizing microscope in the diagnosis of tracheobronchial amyloid-osis, in order to reduce the rate of misdiagnosis.Methods A total of 13 pathological sections positive for Congo red were re-observed, and 104 cases reported since 1987 which had complete clinical data and implicit pathological results were analyzed.Results Of the 13 pathological sections, 8 showed apple-green birefringence when viewed under polar-izing microscope.If the diagnosis of amyloidosis was based on Congo red staining only, it would result in 39.5%false positive cases, which might indciate that 40 cases might be misdiagnosed among the 104 confirmed cases.Conclusion Only when both Congo red staining and polarizing microscope show positive results, can we diagnose the case as PTBA.

关 键 词：原发性气管支气管淀粉样变 假阳性 偏振光显微镜 误诊 

分 类 号：R562.1[医药卫生—呼吸系统] R562.2[医药卫生—内科学]