组织细胞坏死性淋巴结炎35例临床病理及免疫表型研究.docVIP

组织细胞坏死性淋巴结炎35例临床病理及免疫表型研究 ［ ］目的探讨组织细胞坏死性淋巴结炎的临床和病理 学特点。方法回顾性分析35例组织细胞坏死性淋巴结炎 的临床资料。结果35例患者主要表现为单发或多发淋巴结 肿大，并有持续性发热，淋巴结活检可见不同程度的凝固性 坏死伴多种形态的组织细胞、淋巴细胞浸润，免疫组化染色 显示组织细胞及T细胞较多，很少见到B细胞。结论组织 细胞坏死性淋巴结炎临床表现无特异性，显微镜下淋巴结结 构破坏，常见凝固性坏死，细胞异型性较大，容易误诊为淋 巴瘤、结核，必须认真阅片，结合病史，避免误诊。 ［关键词］组织细胞坏死性淋巴结炎；临床病理；免疫 表型 ［ ］R55 ［ ］B ［ ］ 1673-9701 (2012) 30-0102-02 Clinical and pathological analysis of 35 cases histiocytic necrotizing lymphadenitis YANG Baojunl, 2 LI Wencai3 1.Zhengzhou University Basic Medical College, Zhengzhou 450052，China； 2. Department of Pathology， Zhongping Nenghua Medical Group General Hospital , Pingdingshan 467000，China； 3. Department of Pathology, First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052， China [Abstract] Objective To investigate the clinical, pathological characteristics of histiocytic necrotizing lymphadenitis. Methods Retrospective analysis of the clinical data of 35 patients histiocytic necrotizing lymphadenitis. Results The main performance of 35 cases was single or multiple lymphs enlarged node, and persistent fever； the lymph node biopsy showed different degree of coagulative necrosis with various forms of organization cells, lymphocytes, whose immunohistochemical stain reveals many organization cells and T cells, less B cells. Conclusion The histiocytic necrotizing lymphadenitis has not a specific clinical manifestations, the lymph node structure under the microscope is often destroyed, which is commonly coagulative necrosis, and bigger cellular atypia； it is easy to be misdiagnosed for lymphoma、 tuberculosis； with careful observation of pathological slide, combining with the history, it can avoid misdiagnosis. [Key words] Histiocytic necrotizing lymphadenitis； Clinical pathology； Immunotype 组织细胞坏死性淋巴结炎(histiocytic necrotizing lymphadenitis, HNL)是一种特殊类型的非肿瘤性疾病，是 一种良性、自限性、全身性疾病。HNL好发于青年女性，近 年发病率呈上升趋势，2002年1月?2011年12月我院共诊 断组织细胞坏死性淋巴结炎35例，现报道如下。 1资料与方法 1. 1临床资料 本组病例35例，其中男15例，女20例，年龄14?40 岁，平均24.5岁。以颈部淋巴结肿大常见，仅颈部淋巴结 肿大有18例，颈部、腋下及腹股沟淋巴结同时肿大