Kumar P V, Moosavi A, Karimi M, Safaei A, Noorani H, Abdollahi B, Bedayat G R
Department of Pathology, Shiraz Medical School, Shiraz University of Medical Sciences, Iran.
Acta Cytol. 2001 Jul-Aug;45(4):547-54. doi: 10.1159/000327863.
To describe the cytologic findings of localized Leishmania lymphadenitis and discuss the differential diagnosis.
The study group consisted of 133 cases. All of them were diagnosed by fine needle aspiration (FNA) study. The ages ranged between 3 and 80 years, 102 were male and 31 female. Seventy lymph nodes were excised.
The FNA smears revealed a polymorphic population of cells composed of lymphocytes, histiocytes, giant cells, abnormal plasma cells and tingible body macrophages. Leishman-Donovan (LD) bodies were identified in all cases, but their number differed from case to case. Granulomas, dendritic cells, mast cells and lymphoglandular bodies were identified in a substantial number of cases. Depending upon the presence of characteristic cytologic findings, the cases were divided into five major groups: acute inflammation with giant cells, histiocytic granulomas, epithelioid cell granulomas, plasma cell type and mixed histioplasmacytic type.
Leishmaniasis is an uncommon cause of cervical lymphadenitis but should be considered in the differential diagnosis of unexplained lymphadenopathy in endemic countries. Demonstration of LD bodies is necessary for the diagnosis of this self-limited condition, for which no treatment is required.
描述局限性利什曼原虫淋巴结炎的细胞学表现并讨论鉴别诊断。
研究组由133例病例组成。所有病例均通过细针穿刺抽吸（FNA）检查确诊。年龄范围在3岁至80岁之间，男性102例，女性31例。切除了70个淋巴结。
FNA涂片显示细胞多形性，包括淋巴细胞、组织细胞、巨细胞、异常浆细胞和含铁血黄素巨噬细胞。所有病例均发现利什曼-多诺万（LD）小体，但数量因病例而异。在大量病例中发现了肉芽肿、树突状细胞、肥大细胞和淋巴腺小体。根据特征性细胞学表现的存在情况，将病例分为五大组：伴有巨细胞的急性炎症、组织细胞肉芽肿、上皮样细胞肉芽肿、浆细胞型和混合组织细胞型。
利什曼病是颈淋巴结炎的罕见病因，但在流行国家不明原因淋巴结病的鉴别诊断中应予以考虑。对于这种自限性疾病，诊断时必须发现LD小体，无需治疗。
