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首页> 外文期刊>American Journal of Surgical Pathology >Distinctive patterns of transthyretin amyloid in salivary tissue: A clinicopathologic study of 92 patients with amyloid-containing minor salivary gland biopsies
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Distinctive patterns of transthyretin amyloid in salivary tissue: A clinicopathologic study of 92 patients with amyloid-containing minor salivary gland biopsies

机译：唾液组织中的Transthyretin淀粉样蛋白的独特模式：92例含淀粉样蛋白微生物腺体活组织检查患者的临床病理学研究

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Accurate typing of amyloidosis is still a major issue for pathologists and clinicians. Besides clinical data and immunohistochemistry, the histologic distribution of amyloid could represent a useful tool to prevent typing errors, such as the misdiagnosis of hereditary and senile amyloidosis as light chain-related amyloidosis (AL). Minor salivary gland biopsy (MSGB) is a widely performed procedure for amyloidosis diagnosis and typing. In the largest clinicopathologic series of amyloid-containing MSGB specimens to date, we investigated for the first time whether amyloidosis subtypes can be distinguished according to their pattern of salivary amyloid deposition. The histologic distribution and semiquantification of amyloid within salivary tissue were thoroughly reassessed for each case using Congo red-fluorescence. Clinical data were retrospectively collected. The cohort included 92 patients with amyloid-containing minor salivary gland biopsies. The type of amyloidosis was AL in 51 patients (55.4%), non-V30M mutant ATTR in 10 (10.9%), V30M mutant ATTR in 8 (8.7%), serum amyloid A-derived amyloidosis (AA) in 6 (6.5%), wild-type ATTR in 4 (4.3%), gelsolin in 3 (3.3%), and unclassified in 10 (10.9%). Amyloid was more abundant in AL and AA compared with ATTR amyloidosis, because of more extensive basement membranes and vascular deposits. Conversely, non-V30M mutant ATTR and wt-ATTR were strongly associated with peculiar amyloid nodules located in close contact with salivary excretory ducts, with a specificity of 91.7%. In conclusion, our study suggests for the first time that MSGB, in addition to its high sensitivity for amyloidosis diagnosis, is a simple and effective tool for the recognition of ATTR amyloidosis. ? Copyright ? 2015 Wolters Kluwer Health, Inc. All rights reserved.
机译：准确打字的淀粉样症仍然是病理学家和临床医生的主要问题。除了临床数据和免疫组织化学之外，淀粉样蛋白的组织学分布可以代表一种防止打字误差的有用工具，例如遗传性和老年淀粉样蛋白病的误诊为与轻链相关的淀粉样蛋白病（Al）。轻微的唾液腺活组织检查（MSGB）是淀粉样蛋白诊断和打字的广泛进行的方法。在迄今为止最大的含淀粉样蛋白的MSGB标本系列中，我们首次调查了淀粉样蛋白亚型是否可以根据其唾液淀粉样蛋白沉积的模式来区分。使用刚果红荧光的每种情况，彻底重新评估唾液组织内淀粉样蛋白的组织学分布和半化。回顾性收集临床数据。队列包括92名含淀粉样蛋白的轻唾液腺活组织检查患者。淀粉样蛋白症的类型是51名患者（55.4％），非V30M突变体attr在10（10.9％），V30M突变体attr在8（8.7％），6例（8.7％），6（6.5％） ），野生型attr在4（4.3％），露珠蛋白，3（3.3％），在10（10.9％）中未分类。淀粉样蛋白在Al和Aa中更丰富，与attr淀粉样蛋白病相比，由于更广泛的基底膜和血管沉积物。相反，非v30m突变体attr和wt- att与位于与唾液放射性管道紧密接触的特殊淀粉样蛋白结节强烈相关，特异性为91.7％。总之，我们的研究表明，除了对淀粉样症诊断的高灵敏度外，MSGB首次表明是一种简单有效的识别attr淀粉样症状的工具。还版权？ 2015 Wolters Kluwer Health，Inc。保留所有权利。

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