Amrikachi M, Krishnan B, Finch C J, Shahab I
Department of Pathology, Baylor College of Medicine, Veterans Affairs Medical Center, Houston, TX 77030, USA.
Arch Pathol Lab Med. 2000 Oct;124(10):1502-5. doi: 10.5858/2000-124-1502-AAAAAA.
We present 2 unusual cases of long-standing, extensive reactive lymphadenopathy secondary to Actinomyces infection, 1 of which was also accompanied by Actinobacillus actinomycetemcomitans-Actinomyces complex infection. To our knowledge, histologic features of lymph node involvement by these organisms have not been previously reported in the literature. One patient had extensive cervical, posterior mediastinal, and abdominal lymphadenopathy. The second patient presented with a submandibular mass and cervical lymphadenopathy. Clinical features strongly suggested lymphoma. The histologic examination of the lymph nodes from both patients revealed reactive follicular hyperplasia, marked interfollicular and capsular fibrosis, and multiple interfollicular microabscesses. Characteristic Actinomyces colonies were identified at the center of the microabscesses in deep sections. Cultures were obtained from the lymph nodes of 1 patient, and were positive for A actinomycetemcomitans. Both patients had poor dental hygiene. Lymphadenopathy subsided with antibiotic therapy and appropriate dental care.
我们报告了2例罕见的长期广泛的放线菌感染继发反应性淋巴结病病例，其中1例还伴有伴放线放线杆菌-放线菌复合体感染。据我们所知，此前文献中尚未报道过这些微生物累及淋巴结的组织学特征。1例患者有广泛的颈部、后纵隔和腹部淋巴结病。第2例患者表现为下颌下肿块和颈部淋巴结病。临床特征强烈提示淋巴瘤。对2例患者的淋巴结进行组织学检查，结果显示反应性滤泡增生、显著的滤泡间和包膜纤维化以及多个滤泡间微脓肿。在深部切片的微脓肿中心发现了特征性的放线菌菌落。从1例患者的淋巴结中进行了培养，结果为伴放线放线杆菌阳性。2例患者口腔卫生均较差。经抗生素治疗和适当的口腔护理后，淋巴结病消退。
