淋巴细胞性心肌炎:来自心血管病理学会和欧洲心血管病理学协会的遗传病理学定义和分类. II:手术和尸检样本
Joseph J Maleszewski1, Jytte Banner2, Hans de Boer3
1Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA.
概括
新的标准标准化了在非活检心脏样本中诊断淋巴细胞性心肌炎的标准. 这些指导方针在临床和法医环境中提高了活跃心肌炎和含有不确定意义的淋巴细胞透物 (LIUS) 的一致性.
科学领域:
- 心血管病理学心血管病理学
- 组织病理学 组织病理学
- 心肌疾病 心肌疾病
背景情况:
- 淋巴细胞性心肌炎的诊断依赖于内心肌瘤活检的既定标准.
- 对于诸如手术切除和尸检样本之类的非活检样本,缺乏标准化的组织病理学标准.
- 这些非活检样本在临床和法医学上越来越重要.
研究的目的:
- 开发和建立标准化组织病理学标准,用于诊断和分类非透析室腔心肌样本中的淋巴细胞心肌炎.
- 解决在手术和尸检环境中需要一致的解释的需求.
主要方法:
- 一个由心血管病理学家组成的国际小组开发了一个基于共识的分类系统.
- 这些标准是通过合作会议建立的,最终形成了"海港"标准.
- 建议涵盖样本处理,诊断值和慢性质量标准.
主要成果:
- 在非活检样本中淋巴细胞性心肌炎的正式定义:淋巴细胞占主导地位的炎症与可归因的肌细胞损伤.
- 确立的诊断类别:活性心肌炎和含有不确定意义的淋巴细胞透物 (LIUS).
- 解决了尸检因果关系的挑战,提供了辅助技术的指导,并指出了当前的局限性.
结论:
- 开发的共识标准为在非活检样本中诊断淋巴细胞心肌炎提供了标准化的框架.
- 预计采用将提高诊断的一致性,研究可比性和临床/法医评估.
- 未来的工作应该完善肌细胞损伤的定义,验证技术,并澄清炎症的临床意义没有伤害.
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