Kaiserling E
Institute of Pathology, University of Tübingen, Tübingen, Germany.
Lymphology. 2001 Mar;34(1):22-9.
Routine diagnostic work revealed cell aggregates reminiscent of lymph nodes in the bowel submucosa in occasional cases of chronic inflammatory bowel disease. We therefore investigated whether they fulfill criteria for classification as lymph nodes.
Colon with terminal ileum from a patient with florid Crohn's disease and a colectomy specimen from a patient with ulcerative colitis were investigated. Sections were immunostained with antibodies that recognize endothelial and sinus-lining cells, immune-accessory cells, and lymphoid cells.
Circumscribed collections of cells that fulfill all the major criteria for classification as lymph nodes were found in the large and small bowel. They had marginal and intermediate sinuses (positive for BMA 120, CD34, CD31, X-11, and von Willebrand's factor), afferent lymph vessels, T- and B-regions, and a capsule. Small collections composed predominantly of B cells that had only a marginal sinus were also occasionally observed.
Secondary mucosa-associated lymphoid tissue, typically seen as follicular lymphoid hyperplasia, also appears to occur as secondary submucosal lymph nodes. This phenomenon seems inconsistent with the notion that lymph nodes do not develop after birth. We have also noted secondary development of lymph nodes in lymphangioma and lymphangioleiomyomatosis. It is possible that local lymph vessel proliferation, possibly with chronic lymphedema of the tissue involved, is an important prerequisite for lymph node neogenesis.
在慢性炎症性肠病的偶发病例中，常规诊断工作发现肠黏膜下层有类似淋巴结的细胞聚集物。因此，我们研究了它们是否符合淋巴结的分类标准。
对一名患有活动性克罗恩病患者的结肠及回肠末端，以及一名溃疡性结肠炎患者的结肠切除标本进行研究。切片用识别内皮细胞和窦衬细胞、免疫辅助细胞及淋巴细胞的抗体进行免疫染色。
在大肠和小肠中发现了符合淋巴结所有主要分类标准的局限性细胞聚集物。它们有边缘窦和中间窦（BMA 120、CD34、CD31、X-11和血管性血友病因子呈阳性）、输入淋巴管、T细胞区和B细胞区以及包膜。偶尔也观察到主要由B细胞组成且只有边缘窦的小聚集物。
通常表现为滤泡性淋巴组织增生的继发性黏膜相关淋巴组织，似乎也以继发性黏膜下淋巴结的形式出现。这种现象似乎与出生后淋巴结不会发育的观点不一致。我们还在淋巴管瘤和淋巴管平滑肌瘤病中注意到淋巴结的继发性发育。局部淋巴管增生，可能伴有受累组织的慢性淋巴水肿，可能是淋巴结新生的重要先决条件。
