Kelly C A, Malcolm A J, Griffiths I
Ann Rheum Dis. 1987 Mar;46(3):224-7. doi: 10.1136/ard.46.3.224.
Lymph node biopsy specimens from 22 patients with chronic inflammatory joint disease have been studied. The histology has been reviewed and immunoperoxidase staining carried out for the major immunoglobulin heavy and light chains, macrophage markers, and MT1, MB1 surface markers. Although two of these patients had been initially diagnosed and treated for malignant lymphoma, the clinical course has not substantiated the diagnosis, and on review malignancy could not be identified in any of the biopsy specimens. Careful attention to specific histological features, together with adequate clinical information, is therefore essential if the true nature of the lymph node enlargement is to be recognised. Clinical review of the 22 patients suggested that lymphadenopathy may, in some cases, be an early feature of inflammatory polyarthritis, and this was supported by the observation that 20% of patients with otherwise unexplained reactive lymphadenopathy developed an inflammatory polyarthropathy within one year of biopsy.
对22例慢性炎性关节病患者的淋巴结活检标本进行了研究。回顾了组织学情况，并对主要免疫球蛋白重链和轻链、巨噬细胞标志物以及MT1、MB1表面标志物进行了免疫过氧化物酶染色。尽管其中两名患者最初被诊断为恶性淋巴瘤并接受了治疗，但临床病程并未证实该诊断，复查时在任何活检标本中均未发现恶性病变。因此，如果要识别淋巴结肿大的真正性质，仔细关注特定的组织学特征并结合充分的临床信息至关重要。对这22例患者的临床复查表明，在某些情况下，淋巴结病可能是炎性多关节炎的早期特征，活检后一年内，20%原本原因不明的反应性淋巴结病患者出现炎性多关节炎，这一观察结果支持了上述观点。
