Yoshino T, Mannami T, Ichimura K, Takenaka K, Nose S, Yamadori I, Akagi T
Department of Pathology, Internal Medicine Okayama University Medical School, Okayama, Japan.
Hum Pathol. 2000 Oct;31(10):1328-31. doi: 10.1053/hupa.2000.18504.
Histiocytic necrotizing lymphadenitis (HNL) is often mistaken for malignant lymphoma clinically and is also sometimes difficult to differentiate from lymphoma even histopathologically. In this report, we describe the first 2 reported cases of HNL following non-Hodgkin's lymphomas. The patients were 27- and 30-year-old women who developed cervical and axillary lymph node swellings, respectively, in the course of remission of diffuse large B-cell lymphoma. The affected lymph nodes showed the typical histology of HNL: irregular-shaped "necrotic" foci with histiocytes engulfing apoptotic bodies intermingled with large-sized blastic lymphocytes. These findings mimicked the partial involvement of large-cell lymphoma. However, the blastic cells were almost exclusively T cells, and numerous apoptotic bodies were present, which excluded the possibility of recurrence of diffuse large B-cell lymphoma.
组织细胞坏死性淋巴结炎(HNL)在临床上常被误诊为恶性淋巴瘤,甚至在组织病理学上有时也难以与淋巴瘤相鉴别。在本报告中,我们描述了首例报道的2例非霍奇金淋巴瘤后发生的HNL病例。患者为27岁和30岁女性,分别在弥漫性大B细胞淋巴瘤缓解过程中出现颈部和腋窝淋巴结肿大。受累淋巴结表现出HNL的典型组织学特征:不规则形的“坏死”灶,组织细胞吞噬凋亡小体,其间夹杂着大的母细胞样淋巴细胞。这些表现类似于大细胞淋巴瘤的部分受累情况。然而,母细胞几乎均为T细胞,且存在大量凋亡小体,排除了弥漫性大B细胞淋巴瘤复发的可能性。