Bookhout Christine E, Rollins-Raval Marian A
Department of Pathology and Laboratory Medicine, University of North Carolina, Campus Box 7525, Brinkhous-Bullitt Building, Chapel Hill, NC 27599-7525, USA.
Department of Pathology and Laboratory Medicine, University of North Carolina, Campus Box 7525, Brinkhous-Bullitt Building, Chapel Hill, NC 27599-7525, USA.
Surg Pathol Clin. 2016 Mar;9(1):117-29. doi: 10.1016/j.path.2015.09.005.
Immunoglobulin G4-related lymphadenopathy (IgG4-RLAD) occurs in the setting of extranodal IgG4-related disease (IgG4-RD), an immune-mediated process described in many organ systems characterized by lymphoplasmacytic infiltrates with abundant IgG4-positive plasma cells and fibrosis. Although the morphologic features in the lymph node sometimes resemble those seen at the extranodal sites, 5 microscopic patterns have been described, most of which resemble reactive lymphoid hyperplasia. This morphologic variability leads to unique diagnostic challenges and a broad differential diagnosis. As IgG4-RD may be exquisitely responsive to steroids or other immunotherapy, histologic recognition and inclusion of IgG4-RLAD in the differential diagnosis is vital.
免疫球蛋白G4相关性淋巴结病（IgG4-RLAD）发生于结外免疫球蛋白G4相关性疾病（IgG4-RD）的背景下，IgG4-RD是一种免疫介导的过程，在许多器官系统中都有描述，其特征为淋巴细胞和浆细胞浸润，伴有大量IgG4阳性浆细胞和纤维化。尽管淋巴结的形态学特征有时类似于结外部位所见，但已描述了5种微观模式，其中大多数类似于反应性淋巴样增生。这种形态学变异性导致了独特的诊断挑战和广泛的鉴别诊断。由于IgG4-RD可能对类固醇或其他免疫疗法有极佳的反应，因此在鉴别诊断中对IgG4-RLAD进行组织学识别并纳入其中至关重要。
