Valente R M, Banks P M, Conn D L
Division of Rheumatology and Internal Medicine, Mayo Clinic, Rochester, MN 55905.
J Rheumatol. 1989 Mar;16(3):349-54.
Adult onset Still's disease is an acknowledged cause of fever of unknown origin. Eight patients with adult onset Still's disease each had a lymph node biopsy as part of their initial evaluation. Seven of 8 biopsies exhibited intense, somewhat atypical, paracortical immunoblastic hyperplasia. This nodal histology, while not specific for the disorder, appears distinct from that associated with rheumatoid arthritis, Sjögren's syndrome, and systemic lupus erythematosus. This paracortical cellular proliferation with apparent nodal effacement, along with atypical immunoblasts, can simulate lymphoma. Adult onset Still's disease should be added to the differential consideration of benign lymph node histology simulating lymphoma.
成人斯蒂尔病是不明原因发热的公认病因。8例成人斯蒂尔病患者在初始评估时均进行了淋巴结活检。8例活检中有7例表现为强烈的、 somewhat atypical、副皮质区免疫母细胞增生。这种淋巴结组织学表现虽然并非该疾病所特有，但似乎与类风湿关节炎、干燥综合征和系统性红斑狼疮相关的表现不同。这种伴有明显淋巴结结构消失的副皮质区细胞增殖，以及非典型免疫母细胞，可能会模拟淋巴瘤。在鉴别诊断模拟淋巴瘤的良性淋巴结组织学时，应将成人斯蒂尔病纳入考虑范围。 （注：原文中“somewhat atypical”不太明确准确意思，暂保留英文表述）
