Gru Alejandro A, O'Malley Dennis P
Departments of Pathology & Dermatology, University of Virginia, Charlottesville, VA, USA.
Neogenomics, Aliso Viejo, CA, USA.
Semin Diagn Pathol. 2018 Jan;35(1):34-43. doi: 10.1053/j.semdp.2017.11.015. Epub 2017 Nov 28.
This article will provide a discussion of some common autoimmune disorders that could affect the lymph nodes and potentially mimic B and T-cell lymphomas. Some of these disorders are more characteristic of individuals in the pediatric age group (autoimmune lymphoproliferative syndrome, Kawasaki disease), while others present in older individuals (rheumatoid arthritis, lupus erythematosus, sarcoidosis). A common finding that groups all of these disorders together is the overall relative preservation of the architecture, a feature that can be particularly helpful to distinguish them from many B and T-cell lymphomas. Another area of interest, that will be discussed in this review, is the pathologic manifestations that can be present in lymph nodes secondary to medications. Such alterations range from 'reactive' forms of follicular, interfollicular or paracortical hyperplasia, to specific B and T-cell lymphoproliferative disorders (particularly documented in association with methotrexate and TNF-inhibitors).
本文将讨论一些可能影响淋巴结并可能模仿B细胞和T细胞淋巴瘤的常见自身免疫性疾病。其中一些疾病在儿童年龄组个体中更具特征性(自身免疫性淋巴增殖综合征、川崎病),而其他疾病则出现在年龄较大的个体中(类风湿性关节炎、红斑狼疮、结节病)。将所有这些疾病归为一组的一个常见发现是结构的整体相对保留,这一特征对将它们与许多B细胞和T细胞淋巴瘤区分开来特别有帮助。本综述还将讨论另一个感兴趣的领域,即药物继发于淋巴结的病理表现。此类改变范围从滤泡、滤泡间或副皮质增生的“反应性”形式,到特定的B细胞和T细胞淋巴增殖性疾病(特别是与甲氨蝶呤和肿瘤坏死因子抑制剂相关的记录)。