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目的探讨组织细胞性坏死性淋巴结炎(HNL)的临床及病理特点。方法回顾性分析41例HNL的临床病理资料及免疫组织化学表型。结果41例中女性23例,平均年龄21岁。37例颈部淋巴结肿大,半数有发热,2例有皮疹。33例外周血白细胞计数正常,8例减低;血细胞沉降率增快。2例分别在1个月和5年后患系统性红斑狼疮(SLE)。病理形态见在活跃的反应性增生淋巴结病变的背景下,出现程度不同的凝固性坏死,伴有多种形态的组织细胞增生,细胞内外见大量碎片。病变区及周围有免疫母细胞及浆样单核细胞增生,无中性粒细胞浸润。组织细胞CD68(+),淋巴细胞CD3和CD45RO(+)。结论HNL为淋巴结反应性增生的特殊表现,多见于年轻女性,常为单侧颈部淋巴结肿大伴发热,与SLE等诸多疾病相关,易误诊为恶性淋巴瘤,需引起警惕。
Objective To investigate the clinical and pathological features of histiocytic necrotizing lymphadenitis (HNL). Methods The clinicopathological data and immunohistochemical phenotype of 41 cases of HNL were retrospectively analyzed. Results 41 cases of female 23 cases, mean age 21 years. 37 cases of cervical lymph nodes, half have fever, 2 cases have a rash. 33 cases of peripheral blood leukocyte count was normal, 8 cases reduced; hematological cell sedimentation rate increased. Two patients had systemic lupus erythematosus (SLE) at 1 month and 5 years respectively. Pathological changes seen in the active reactive hyperplasia of lymph node lesions in the context of varying degrees of coagulation necrosis, accompanied by a variety of forms of tissue cell proliferation, see a large number of intracellular and extracellular debris. Lesions and surrounding immune cells and plasma-like mononuclear cell proliferation, no neutrophil infiltration. Tissue cells CD68 (+), lymphocytes CD3 and CD45RO (+). Conclusion HNL is a special manifestation of reactive lymph node hyperplasia. It is more common in young women. It is often associated with fever of unilateral neck lymph nodes. It is associated with many diseases such as SLE. It may be misdiagnosed as malignant lymphoma and needs vigilance.