Human Pathology
Volume 41, Issue 2 , Pages 249-254, February 2010

Imprint cytology detects floating Brachyspira in human intestinal spirochetosis☆☆☆★

  • Sho Ogata, MD, PhD

      Affiliations

    • Division of Medicine, Japan Self Defense Forces Hospital Yokosuka, Yokosuka 237-0071, Japan
    • Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa 359-8513, Japan
    • Corresponding Author InformationCorresponding author. Department of Pathology and Laboratory Medicine, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama 359-8513, Japan.
    • ,
  • Masaaki Higashiyama, MD

      Affiliations

    • Division of Medicine, Japan Self Defense Forces Hospital Yokosuka, Yokosuka 237-0071, Japan
    • ,
  • Yoshikazu Adachi, DVM, PhD

      Affiliations

    • Department of Cell Physiology, School of Agriculture, Ibaraki University, Ibaraki 300-0393, Japan
    • ,
  • Ichiyo Ohara, MD, PhD

      Affiliations

    • Division of Medicine, Japan Self Defense Forces Hospital Yokosuka, Yokosuka 237-0071, Japan
    • ,
  • Junichiro Nishiyama, MD, PhD

      Affiliations

    • Division of Medicine, Japan Self Defense Forces Hospital Yokosuka, Yokosuka 237-0071, Japan
    • ,
  • Yasushi Okusa, MD, PhD

      Affiliations

    • Division of Medicine, Japan Self Defense Forces Hospital Yokosuka, Yokosuka 237-0071, Japan
    • ,
  • Hiroaki Takeo, MD, PhD

      Affiliations

    • Department of Pathology, Japan Self Defense Forces Central Hospital, Setagaya, Tokyo 154-8532, Japan
    • ,
  • Kimiya Sato, MD, PhD

      Affiliations

    • Department of Pathology, Japan Self Defense Forces Central Hospital, Setagaya, Tokyo 154-8532, Japan
    • ,
  • Kuniaki Nakanishi, MD, PhD

      Affiliations

    • Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa 359-8513, Japan
    • ,
  • Toshiaki Kawai, MD, PhD

      Affiliations

    • Department of Pathology and Laboratory Medicine, National Defense Medical College, Tokorozawa 359-8513, Japan

Received 19 June 2009; received in revised form 22 July 2009; accepted 30 July 2009. published online 16 October 2009.

Summary 

Human intestinal spirochetosis is a colorectal infectious disease caused by 2 Brachyspira species. Its diagnosis is established by histology, culture, and polymerase chain reaction, but the value of cytologic examination in routine practice remains unclear. In this study, imprint cytology of biopsy specimens was examined for cytologic features specific to human intestinal spirochetosis. Specimens were obtained from 65 colorectal regions (1–3 regions from each case) in 25 ultrastructurally and/or genetically confirmed human intestinal spirochetosis cases (20 with Brachyspira aalborgi, 3 with B pilosicoli, 2 with both genotypes). In cytologic specimens, spirochetes tended to be floating freely within the mucus and intestinal fluid, whereas the “fringe formation” of spirochetes typically observed in histologic specimens was indistinct in cytologic specimens. Spirochetes were identified in 58 regions (89.2%) and 23 cases (92.0%) by cytology, against in 50 regions (76.9%) and 22 cases (88.0%) by histology (no significant differences). In 6 of 8 regions exhibiting positive cytology and negative histology, B pilosicoli was present within the mucus. Hence, B pilosicoli may tend to float in the mucus. In conclusion, cytologic examination would be useful for the routine identification of human intestinal spirochetosis, especially if B pilosicoli is involved. Further, we suggest the existence of differences in biological behavior between these spirochetes.

Keywords: Brachyspira, Cytology, Genotype, Spirochetosis

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☆ The contents of this article were presented at the 5th International Conference of Intestinal Spirochaetal Infections in Animals and Humans on June 8, 2009, in Leon, Spain.

☆☆ This work was supported in part by a grant from the Japan Ministry of Defense (to S. O.).

★ The views expressed in this article are those of the authors and do not reflect the official policies of the Japan Ministry of Defense or the Japan Self Defense Forces.

PII: S0046-8177(09)00282-2

doi:10.1016/j.humpath.2009.07.020

Human Pathology
Volume 41, Issue 2 , Pages 249-254, February 2010

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