Expanded teased nerve fibre pathological conditions in disease association

病态的 病理 医学 多神经根神经病 疾病 多发性神经病 淀粉样蛋白(真菌学) 神经纤维 解剖 免疫学 格林-巴利综合征
作者
Min Xu,Marcus Vinícius Pinto,Chenjing Sun,JaNean Engelstad,P. James B. Dyck,P. James B. Dyck,Christopher J. Klein
出处
期刊:Journal of Neurology, Neurosurgery, and Psychiatry [BMJ]
卷期号:90 (2): 138-140 被引量:16
标识
DOI:10.1136/jnnp-2018-319077
摘要

Objective To describe an expanded teased nerve fibre classification in disease association. Methods We reviewed four newly proposed teased nerve fibre types ( Types J–M ): Type J, rope-like fibres; K, fibril-like clumps of osmium positivity; L, cellular debris along and within nerve fibres; M, circular axonal inclusions surrounded by thin myelin. Different clinical pathological entities were studied for these fibre types including chronic inflammatory demyelinating polyradiculoneuropathy (CIDP: N=20); amyloid polyneuropathy (N=20); intraneural B-cell lymphoma (N=20) or adult-onset polyglucosan body disease (APBD: N=6) in comparison with 112 disease controls. Student’s t-test was used to test significance of association between the identified fibre types and the specific clinical diagnosis. Results Each fibre type significantly associated (p<0.001) with particular disease categories: Type J , 60% of CIDP cases; Type K , 75% of amyloid cases; Type L , 75% of intraneural lymphoma cases; Type M , 100% of APBD cases. Rarely were these fibres found in the other disease control cases ≤3% of cases. In three cases, the teased fibre findings were so striking additional paraffin nerve preparations were made to make the pathological diagnosis when initial paraffin sections were non-diagnostic. Conclusions Teased nerve fibre Types J–M associate with commonly seen pathological diagnosis and are helpful in the consideration of specific neuropathy diagnoses.
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