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伴有巨大淋巴结病的窦组织细胞增生症(罗萨伊和多夫曼病)及明显皮肤受累

Sinus histiocytosis with massive lymphadenopathy (Rosai and Dorfman) and significant skin involvement.

作者信息

Tanaka N, Asao T

出版信息

Acta Pathol Jpn. 1978 Jan;28(1):175-84. doi: 10.1111/j.1440-1827.1978.tb01258.x.

Abstract

Clinicopathological features of this female patient described here, showing unusual and extremely marked sinus histiocytosis of lymph nodes with considerable systemic lymphadenopathy, accompanying fever as well as acceleration of erythrocyte sedimentation rate fairly well coincided with the symptoms of "Sinus Histiocytosis With Massive Lymphadenopathy" (Rosai and Dorfman). The onset of the present case was in 1966 when the patient was 10 years of age, and she has been followed-up for over 10 years. While persisting to display active clinical manifestations, immunological abnormality with thymus involution was demonstrated--deterioration of cell-mediated immunity, but with non-remarkable humoral immunological data, except for hypergammaglobulinemia with elevation of IgG. In 1973 lymphadenopathy as well as skin eruption extended over the extremities and abnormalities of hematological and serological nature began to improve and at the present date the patient is uneventful. This is the first recorded case of "Sinus Histiocytosis With Massive Lymphadenopathy" (Rosai and Dorfman) in Japan. Considerable skin involvement in the upper and lower extremities was a significant feature and unique in this case.

摘要

本文所述该女性患者的临床病理特征显示,其淋巴结出现异常且极为显著的窦性组织细胞增多,并伴有全身性淋巴结肿大,同时伴有发热以及红细胞沉降率加快,这些表现与“伴巨大淋巴结病的窦性组织细胞增多症”(罗萨伊和多尔夫曼病)的症状相当吻合。本病例于1966年发病,患者当时10岁,至今已随访10余年。患者持续表现出活跃的临床症状,同时伴有胸腺萎缩的免疫异常——细胞介导免疫功能恶化,但体液免疫数据无明显异常,仅IgG升高导致高球蛋白血症。1973年,淋巴结肿大及皮肤疹蔓延至四肢,血液学和血清学性质的异常开始改善,目前患者情况平稳。这是日本首例有记录的“伴巨大淋巴结病的窦性组织细胞增多症”(罗萨伊和多尔夫曼病)病例。上下肢皮肤受累程度相当是本病例的一个显著且独特的特征。

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