Kojima Masaru, Nakamura Shigeo, Yamane Yuko, Tanaka Hiroshi, Masawa Nobuhide
Department of Pathology and Clinical Laboratories, Gunma Cancer Center Hospital, Ohta, Japan.
Pathol Res Pract. 2003;199(10):691-4. doi: 10.1078/0344-0338-00482.
A case of autoimmune disease-associated lymphadenopathy (ADAL) in the lymph nodes linked to well documented dermatomyositis is presented. A 49-year-old Japanese woman was affected by a left axillary and a left inguinal lymphadenopathy at the onset of disease. A biopsy specimen taken from a left inguinal lymph node showed distortion of the nodal architecture and polymorphous lymphoid infiltration containing many plasma cells and plasmacytoid cells with scattered transformed lymphocytes, as well as a large number of capillaries. The polytypic nature of B-lymphocytes was demonstrated by immunohistochemistry and polymerase chain reaction. Epstein-Barr virus-associated lymphoplasmacytic infiltrates may occur in patients immunosuppressed by methotrexate administered for the treatment of dermatomyositis. However, Epstein-Barr virus-encoded small RNA-positive cells were not identified by in situ hybridization. Moreover, the patient had no history of methotrexate therapy.
本文报告了一例与记录完善的皮肌炎相关的淋巴结自身免疫性疾病相关性淋巴结病（ADAL）。一名49岁的日本女性在疾病发作时出现左侧腋窝和左侧腹股沟淋巴结病。从左侧腹股沟淋巴结获取的活检标本显示淋巴结结构扭曲，有多形性淋巴细胞浸润，包括许多浆细胞和浆细胞样细胞，伴有散在的转化淋巴细胞，以及大量毛细血管。免疫组织化学和聚合酶链反应证实了B淋巴细胞的多型性。接受甲氨蝶呤治疗皮肌炎的免疫抑制患者可能会出现爱泼斯坦-巴尔病毒相关的淋巴浆细胞浸润。然而，原位杂交未发现爱泼斯坦-巴尔病毒编码的小RNA阳性细胞。此外，该患者无甲氨蝶呤治疗史。
