Liu Zhiyan, Zhang Chunyan, Kakudo Kennichi, Cui Xiujie, Mu Kun, Zhou Chengjun, Wang Yan, Chen Shiming, Zhou Gengyin
Department of Pathology, Shandong University School of Medicine, Jinan, Shandong, China.
Department of Pathology, Shandong University Qilu Hospital, Jinan, Shandong, China.
Pathol Int. 2016 Mar;66(3):142-147. doi: 10.1111/pin.12384. Epub 2016 Jan 27.
Retrospective study was applied to 16 cases of syphilitic lymphadenitis to elucidate the pathological diagnostic features. The typical morphology of syphilitic lymphadenitis includes: (i) well preserved or partially destroyed lymph node structure; (ii) reactive hyperplasia of lymph follicles with broadened germinal centers in the cortex and medulla of the lymph node; (iii) thickened fibrotic lymph node capsules with infiltration of plasma cells; and (iv) phlebitis and endarteritis in varying degree. Additional morphology includes: (i) focal histiocytes with ingested debris; (ii) noncaseating granuloma with epithelioid histiocytes and disperse giant cells; and (iii) hyperplastic centroblast and occasionally isolated mononuclear Reed-Sternberg cell-like giant cells. Treponema pallidum was identified in 15 of the 16 cases by immunohistochemical staining. The histopathological diagnosis of syphilitic lymphadenitis poses difficulty in differentiation from other infectious or neoplastic lymphadenopathies. The newly established Treponema pallidum antibody is sensitive to identification of Treponema pallidum in formalin fixed paraffin embedded tissue.
对16例梅毒性淋巴结炎患者进行回顾性研究，以阐明其病理诊断特征。梅毒性淋巴结炎的典型形态包括：（i）淋巴结结构保存完好或部分破坏；（ii）淋巴结皮质和髓质中淋巴滤泡反应性增生，生发中心增宽；（iii）淋巴结包膜纤维化增厚，伴有浆细胞浸润；（iv）不同程度的静脉炎和动脉内膜炎。其他形态包括：（i）有吞噬碎片的局灶性组织细胞；（ii）由上皮样组织细胞和散在巨细胞组成的非干酪样肉芽肿；（iii）增生的中心母细胞，偶尔有孤立的单核里德-斯腾伯格细胞样巨细胞。16例中有15例通过免疫组织化学染色鉴定出梅毒螺旋体。梅毒性淋巴结炎的组织病理学诊断在与其他感染性或肿瘤性淋巴结病的鉴别上存在困难。新建立的梅毒螺旋体抗体对在福尔马林固定石蜡包埋组织中鉴定梅毒螺旋体很敏感。
