Isshiki, Takuma Toho University
Homma, Sakae Toho University
Eishi, Yoshinobu Tokyo Medical and Dental University
Yabe, Matsuko Toho University
Yamaguchi, Tetsuo Tokyo Medical and Dental University|Shinjuku Tsurukame Clinic
Uchida, Keisuke Tokyo Medical and Dental University
Yamamoto, Kurara Tokyo Medical and Dental University
Ohashi, Kenichi Tokyo Medical and Dental University
Arakawa, Atsushi Juntendo University
Shibuya, Kazutoshi Toho University
Sakamoto, Susumu Toho University
Kishi, Kazuma Toho University
Propionibacterium acnes is implicated in the pathogenesis of sarcoidosis. We investigated the usefulness of immunohistochemistry (IHC) with a commercially available P. acnes-specific monoclonal antibody (PAB antibody) for differentiating sarcoidosis from other granulomatous diseases. Formalin-fixed paraffin-embedded tissue samples from 94 sarcoidosis patients and 30 control patients with other granulomatous diseases were examined by the original manual IHC method. We also compared the detection frequency of P. acnes in sarcoid granulomas between manual and automated IHC methods. P. acnes was detected in sarcoid granulomas of samples obtained by transbronchial lung biopsy (64%), video-associated thoracic surgery (67%), endobronchial-ultrasound-guided transbronchial-needle aspiration (32%), lymph node biopsy (80%), and skin biopsy (80%) from sarcoidosis patients, but not in any non-sarcoid granulomas of the samples obtained from control patients. P. acnes outside granulomas, however, was frequently detected in both groups. The detection status of P. acnes in granulomas did not correlate with the clinical characteristics of sarcoidosis patients. The automated Leica system exhibited the best detection sensitivity (72%) and almost an identical localization for P. acnes in sarcoid granulomas compared with the manual method. IHC with a PAB antibody is useful for differentiating sarcoidosis from other granulomatous diseases by detecting P. acnes in granulomas. An automated method by the Leica system can be used in pathology laboratories for differential diagnosis of granulomas by IHC with the PAB antibody.
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