临床病理制片常见问题及解决办法

在病理外检工作中常规石蜡切片及染色的质量是保证病理诊断及时、准确的关键。我们在从事病理组织学制片和对病理组织切片的会诊中常常发现，由于切片和染色质量不佳。难以做出准确的病理诊断甚至出现错误的诊断结论。多年来，我们在病理组织制片技术上积累了丰富的经验。现将临床病理制片中常见的问题及解决的办法总结如下。     

非洲猪瘟临床病理特征及生物安全防控

非洲猪瘟(African swine fever,ASF)是一种烈性猪传染病,目前尚无有效商品化疫苗。为控制ASF疫情传播,猪只一旦发病只能扑杀,这对生猪养殖业冲击极大。因此,了解非洲猪瘟临床和病理特征并做好防控措施意义重大。本文论述了猪只患非洲猪瘟的临床和病理学特征,及非洲猪瘟的致病机制,并提出了防控非洲猪瘟疫情几点建议。     

44例宠物犬肿瘤病理诊断及分析

收集北京地区2015~2016年宠物医院的部分宠物犬肿瘤病例56例,采用组织病理学方法进行病理诊断,并对患病动物的品种、发生部位、年龄和性别与肿瘤发生关系进行了统计分析。结果发现,56个病例中有44例确诊为肿瘤,其中良性肿瘤21例,包括肛周腺瘤、皮脂腺瘤和肥大细胞瘤等;恶性肿瘤23例,包括乳腺癌、鳞状上皮细胞癌和肛周腺癌等。本次采集的病例中,大型犬与小型犬发病率持平,皮肤、肛周与乳腺部位肿瘤的发生率较高;7岁以后是肿瘤高发期;雌性犬皮肤和乳腺肿瘤的患病率高于雄性,雄性宠物犬肛周腺肿瘤的发生率高于雌性,肿瘤总患病率雄性与雌性持平。本研究为今后宠物犬肿瘤的流行病学及诊断提供了新的参考资料。     

“临床促教学”在病理实验教学中的应用研究

病理学是一门桥梁学科,也是一门形态学科,实验教学是病理教学中不可或缺的重要组成部分,教学效果的好坏直接决定着学生对病理学理论知识的掌握程度,以及学生对后续临床课程的学习。利用附属医院病理科丰富的临床资源可充实病理实验教学,转变教学方式,提高教学效果,培养学生的临床实践能力,真正意义上实现临床促教学,基础与临床优势资源的整合,对病理学课程实验教学的发展和探索具有重要意义。     

胃肠道间质瘤合并其他肿瘤临床病理分析

目的探讨胃肠道间质瘤合并其他肿瘤的临床病理特点。方法回顾性分析滨州医学院附属医院自2009年-2017年收治的胃肠道间质瘤合并其他胃肠道恶性肿瘤病例32例,分析其合并其他肿瘤的部位、间质瘤的大小等临床病理特征。结果合并其他消化系统肿瘤的胃肠道间质瘤发生部位最常见为胃部24例,胃肠道间质瘤大小均值2.4cm,合并发生的消化系统恶性肿瘤最常见部位为胃部,合并胃癌19例,两者同时累及胃12例。组织学类型中以腺癌为主,其次为鳞状细胞癌。结论合并其他肿瘤的胃肠道间质瘤无特异性临床特征,病理无特异性免疫组化标志。     

38例犬肿瘤的病理诊断及分析

收集深圳市2010年－2012年部分宠物医院的犬肿瘤病例41例，采用组织病理学方法对犬肿瘤病例进行组织学分类，并对患病动物的年龄、性别和发生部位进行了统计分析。38例确诊肿瘤病例中，皮肤肿瘤有19例，包括鳞状细胞癌4例、基底细胞癌5例、乳头状瘤3例，皮脂腺瘤和肛周腺癌各2例，脂肪瘤、黑色素瘤、角化棘皮瘤各1例；乳腺肿瘤9例，包括乳腺癌3例、乳腺鳞状细胞癌2例、乳腺癌肉瘤2例、黏液癌1例，患犬以雌性为主；其他部位肿瘤分别有纤维肉瘤2例，血管瘤、肺癌、淋巴瘤、睾丸精原细胞瘤、睾丸支柱细胞瘤、组织细胞癌、鳞状细胞癌、乳头状瘤各1例。上述结果显示，犬肿瘤的高发部位是皮肤，其次是乳腺，其发生年龄以7岁以上为多，在发病动物的品种上没有明显差别；除乳腺肿瘤外，其余肿瘤的性别差异不大。本研究为犬肿瘤的流行病学及诊断提供了参考依据。     

犬白内障的临床分类及病理特性

眼是动物体的一个光学器官。眼球的结构很复杂，晶状体是调节眼球视觉焦距的屈光体，其功能或形态可发生各种异常，形成不同类型的晶状体病，临床上将影响视力或未明显影响视力的晶状体混浊称为白内障。所有的白内障绝不仅仅是晶状体本身的病变，而是伴有眼部表现的全身性疾病。如果晶状体囊膜或晶状体组织本身失去透明性，则呈现部分或全部混浊。     

犬眼病的临床病理研究

眼是视觉系统中最重要的器官,随着宠物医疗技术的高度发展,犬的眼科疾病日益被临床兽医所重视。事实上眼部疾病常囊括部分全身疾病的局部体征,虽然相关的眼科检查仪器逐步导入临床,使视诊范围日益增宽,但由于缺乏对眼科生理、病理的认识,势必影响对眼科疾病的诊断能力。国外小动物眼科学发展很快,各种高科技检查仪器早已成为临床医生的诊察手段。     

一例犬前肢血管周细胞瘤的病理及免疫组化分析

血管周细胞瘤是一种软组织肉瘤,起源于毛细血管壁的周细胞。在本报道中,描述了一只11岁中华田园犬的左腿腕关节肿块。为确定肿块性质,采用影像学、细胞学和病理学检查加以诊断。X光检查显示肿瘤始于软组织,肿物界限清晰;细胞学检查显示细胞呈梭形,核仁明显,细胞核大小不一;病理组织学结果显示存在围绕血管的梭形细胞;免疫组织化学结果显示波形蛋白和α-SMA阳性表达,desmin和S-100阴性表达,肿瘤组织中PCNA阳性肿瘤细胞的数量大于25%,Masson trichrome染色显示肿瘤组织中胶原纤维的含量少。结合病理学及免疫组化确诊为血管周细胞瘤。     

1例猫肾上腺皮质癌脾转移的病理及免疫组化分析

猫的肾上腺皮质癌转移至脾在兽医临床非常罕见。在本报告中,描述了1例10岁田园猫,其症状表现为腹部疼痛,频繁呕吐,消瘦,有慢性肾上腺功能损伤病史,影像学检查脾肿大。对患猫进行脾摘除手术,并对摘除的组织进行组织病理学检查和免疫组化分析。病理组织学结果显示,肿瘤细胞具有丰富的脂质样空泡,细胞体积大,有丝分裂象多见,且肿瘤细胞已发生血管侵袭,细胞核浓染;免疫组织化学结果显示,synaptophysin、S-100和GATA4阳性表达。根据病理组织学和免疫组织化学及病史和实验室检查,最后诊断为肾上腺皮质癌的脾转移。首次报道了猫肾上腺皮质癌脾转移临床病例及病理学诊断,对于临床相关疾病诊疗有一定的参考价值和借鉴意义。     

Pathological manifestations observed in dead-on-arrival broilers at a Danish abattoir

1. The mortality of broilers during pre-slaughter handling, including harvesting and transport, is an issue of increasing public concern which has led to the adoption of Council Directive EC/43/2007 implementing abattoir surveillance regarding the number of dead-on-arrival (DOA) broilers.

2. Pathological lesions and causes of death of DOA broilers at a Danish abattoir were investigated in a cross-sectional study comprising 300 DOA broilers (25 broilers from each of 12 randomly selected flocks). Major pathological manifestations of DOA broilers included severe pulmonary congestion (51.5%), lung congestion in combination with trauma (12.5%), trauma (10.2%), nephropathy accompanied by dehydration and/or discolouration (8.8%), morbus cordis (2.0%), septicaemia (1.7%) and suspected septicaemia (1.0%). Lung congestion accompanied by circulatory disturbances in other tissues was suggested to be due to suffocation.

3. Analyses of pathological diagnoses revealed that DOA broilers can be divided into two main categories, lung congestion and trauma, based on the chronicity of the lesions, both of which are primarily related to management and handling procedures. Most DOA broilers examined (74.2%) were estimated to have died as a consequence of events during pre-slaughter handling underlining the importance of increased focus on handling-related factors to reduce DOA rate.     

Evidence for a relationship between Leishmania load and clinical manifestations

Visceral leishmaniasis (VL) is a life-threatening disease of medical, social and economic importance in endemic areas. Dogs are the main reservoir of Leishmaniainfantum. In this study, the authors investigated a group of 56 natural infected dogs to establish the relationship between parasite load and various clinical forms of leishmaniasis.The sick dogs were monitored at the beginning from clinical and physiological point of view. Leishmania load was measured by real-time PCR assay on whole blood samples and lymph node aspirates, collected at the time of diagnosis.Our results indicate that a higher quantity of Leishmania DNA was found in the lymph nodes of dogs characterized by maximum clinical score. This interesting finding indicates the presence of a positive relationship between Leishmania load and clinical manifestations in dogs showing a severe clinical form of leishmaniasis.     

Biologic characteristics of mycobacterium strains isolated from cattle from herds with clinical paratuberculosis

In the period from 1983 to 1986, bacteriological examination for paratuberculosis was performed in 263 samples of lymph nodes, intestinal mucous membrane and excrements of cattle, kept on a farm where clinical paratuberculosis occurred. Seventy-nine strains of mycobacteria were isolated during the culturing. On selective agar medium with mycobactin as the growth stimulator, 71 strains were isolated which had failed to grow on the conventional mycobacterium-culturing media. In the subculture, the dependence of mycobacteria on the mycobactin declined and the number of mycobacterium strains growing in the subculture on conventional mycobacting-free media doubled. Two thirds of the mycobacteria which did not depend on mycobactin during growth exhibited the same antigenic properties as Mycobacterium avium 1, 2, 3, 8 during serotypification. Ability to induce sensibility to PPD avian tuberculin or paratuberculin was demonstrated during the bioassays of mycobactin. Almost a half of the strains inducing animals' sensitivity to the above-mentioned allergens were found to be virulent to pullets that had tuberculosis in their parenchymatous organs. Of the laboratory animals, the highest virulence of the mycobactin-dependent mycobacterium strains was demonstrated in mice subjected to intravenous infection, accompanied by hyperplasia of the spleen, with reisolation of the mycobacterium culture within six eight weeks after infection.     

Severe polyuria and polydipsia as major clinical signs in a horse with unilateral renal adenocarcinoma

A 14‐year‐old Swiss Warmblood gelding was presented with chronic severe polyuria, polydipsia and weight loss. At the time of admission, water intake was 240 l/day. On rectal examination, a large mass was identified in the left dorsal abdominal quadrant, which was shown to originate from the left kidney by transabdominal ultrasonographic examination. Unilateral nephrectomy via flank incision was performed under general anaesthesia. Histopathological examination of the tumour revealed a papillary renal adenocarcinoma. Successful outcome and survival was documented 13 months after surgery. Severe polyuria and polydipsia should be considered as major clinical signs for renal carcinoma in horses, which can be successfully treated with unilateral nephrectomy if no signs of metastatic spread are evident.     

The complex etiology of epidemic diseases in calves on large-capacity farms and their clinical and epizootic characteristics

It is not easy to exactly diagnose the etiology of the mass infections of new-born calves on large farms where considerable losses are suffered. On the basis of the complex epizootological, clinical and laboratory examination in four large calf-rearing facilities, rotaviruses, coronaviruses, the infectious bovine rhinotracheitis (IBR) virus and the bovine viral diarrhoea (BVD) virus, and in some cases also the enteropathogenic E. coli, were found to be etiologically involved in the mass rise of diarrhoea, complicated by respiratory symptoms already during the first days after birth. The clinical picture of the disease, therapeutically difficult and reminding of "pneumoenteritis", has often been observed in stocks where, in addition to rotaviruses and coronaviruses in the faeces, the IBR or BVD viruses (sometimes both at the same time) were detected and identified in the respiratory and enteral tract. The serological examination of a higher number of animals in the stocks of calves under study confirmed the considerable rate of spreading of all the four viruses in the cattle population and, at the same time, demonstrated the very unfavourable immunological profile of the herds. The high percentage of animals low in antibody titres and the serologically negative animals constitute the infection-sensitive part of population in the affected herds. With the high culling rate and with the open herd turnover it is impossible to reach the required immunity through natural disinfection. Loss-free rearing of healthy calves will be achieved on the basis of a well-oriented vaccination programme with a good combination of inoculants.     

生长育肥猪常见疾病的临床表现及防控

随着养殖水平不断提高以及居民对猪肉制品消费和需求的不断增加,我国生猪养殖规模的不断扩大,目前生猪存栏量、出栏量均较前期有所提高。我国养猪业在不断发展的同时,也在面临着前所未有的困难和挑战,其中对养猪业和养殖者来说最大的难题,就是猪病的种类不断增加,以及随之不断提升的预防和治疗的难度与成本。特别是对于生长育肥猪来说,一旦患病,便会给养殖者带来巨大的经济损失。文章对目前生猪养殖业中生长育肥猪常见且危害较大的几种疾病的临床表现和防控进行了简要综述。     

Parasitaemia and clinical manifestations in Trypanosoma brucei infected dogs.

Four dogs were infected with Trypanosoma brucei (Mkar strain) while another four were used as uninfected controls. Two of the dogs showed acute disease and died in the first wave of parasitaemia on days 7 and 8 post infection (PI) while the other two died from the sub-acute disease on days 24 and 28 PI corresponding to the second wave of parasitaemia. In the first wave of parasitaemia there was a sharp decrease in the packed cell volume, red blood cell, haemoglobin, total leucocytes, eosinophil, neutrophil and lymphocyte values, but during the period of low parasitaemia there was a slight recovery of the values of total leucocytes and lymphocytes although these and the other values showed a continuous decrease during the second wave of parasitaemia. In contrast, there was a consistent monocytosis in both acute and sub-acute diseases. The general picture was that of loss of condition, anaemia, leucopenia, monocytosis, ocular impairment, elevated temperature, pulse and respiratory rates, the difference between the acute and sub-acute diseases being in the degree of intensity. The degree of anaemia noted and the circulatory disturbances associated with the infection could have caused the death of all the infected dogs.