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Demonstration of rabies virus antigen at autopsy
HUMAN PATHOLOGY
Volume 24, No. 8 (August 1993) However, the reported strong staining in all 89 of their c’ases gives rise to the question as to whether the performed i~~,,~iunollistoche~~lic~tl reaction has suitable levels of sensitivity and specificity. The ability of urothelial carcinoma to produce mucoid substances taken alone serves neither to exclude nor to prove the urothelial origin of metastases. However, detection of mucoid cyroplasmic inclusions in connection with further histologic criteria could be the diagnostic clue in some cases. K. DONHIII.JSEN, MD Institute of Pathology University of Essen Essen, Germany
Demonstration Autopsy
of Rabies Virus Antigen at
To thP Editor:--In their interesting case study Drs Mrak demonstrate the problems of morphologic diagnosis of rabies in autopsy material. First, well-demarcated, round cytoptasmic inclusions were found only after extensive review of dozens of sections of the cerebellum, and even these lacked basophilic inner granules. Second, over 70 epoxy blocks had to he prepared before the rabies virus could be demonstrated ultrastructurally. In this regard, a monoclonat antibody to an epitope of the rabies ribonucleoprotein N (RNP), developed by Dr A. Wandeler (Bern, Switzerland), may be very helpful. The RNP epitope is resistant to formalin fixation and paraffin embedding; therefore, the search for rabies encephalitis can be done successfully on paraffin blocks from the files. In our own studies on paraffin-embedded tissue of patients and animals with rabies,‘-4 we detected virus antigen in nerve cell bodies and processes as well as in glial cells of the central nervous system. The RNP antigen was not limited to the Negri bodies, but also was seen in the cytoplasm. Many more virus infected cells were found than were expected by the presence of Negri bodies.‘,” Rabies virus antigen also was detected in vegetative ganglia of the heart as well as in cardiomyocytes.’ The use of the RNP antibody facilitates the diagnosis or the exclusion of rabies in diagnostic pathology, especially if fresh or frozen tissue is not available. and
Young’
KONRADIN METZE, MD State University of Campinas Campinas-SP, Brazil WOI.F(;ANG FEIDEN, MD, PHD University Hospital of the Saarland Homburg/Saar, Germany
930
Volume 24, No. 8 (August 1993) However, the reported strong staining in all 89 of their c’ases gives rise to the question as to whether the performed i~~,,~iunollistoche~~lic~tl reaction has suitable levels of sensitivity and specificity. The ability of urothelial carcinoma to produce mucoid substances taken alone serves neither to exclude nor to prove the urothelial origin of metastases. However, detection of mucoid cyroplasmic inclusions in connection with further histologic criteria could be the diagnostic clue in some cases. K. DONHIII.JSEN, MD Institute of Pathology University of Essen Essen, Germany
Demonstration Autopsy
of Rabies Virus Antigen at
To thP Editor:--In their interesting case study Drs Mrak demonstrate the problems of morphologic diagnosis of rabies in autopsy material. First, well-demarcated, round cytoptasmic inclusions were found only after extensive review of dozens of sections of the cerebellum, and even these lacked basophilic inner granules. Second, over 70 epoxy blocks had to he prepared before the rabies virus could be demonstrated ultrastructurally. In this regard, a monoclonat antibody to an epitope of the rabies ribonucleoprotein N (RNP), developed by Dr A. Wandeler (Bern, Switzerland), may be very helpful. The RNP epitope is resistant to formalin fixation and paraffin embedding; therefore, the search for rabies encephalitis can be done successfully on paraffin blocks from the files. In our own studies on paraffin-embedded tissue of patients and animals with rabies,‘-4 we detected virus antigen in nerve cell bodies and processes as well as in glial cells of the central nervous system. The RNP antigen was not limited to the Negri bodies, but also was seen in the cytoplasm. Many more virus infected cells were found than were expected by the presence of Negri bodies.‘,” Rabies virus antigen also was detected in vegetative ganglia of the heart as well as in cardiomyocytes.’ The use of the RNP antibody facilitates the diagnosis or the exclusion of rabies in diagnostic pathology, especially if fresh or frozen tissue is not available. and
Young’
KONRADIN METZE, MD State University of Campinas Campinas-SP, Brazil WOI.F(;ANG FEIDEN, MD, PHD University Hospital of the Saarland Homburg/Saar, Germany
930