Burke J S, Osborne B M
Am J Surg Pathol. 1983 Jun;7(4):373-80. doi: 10.1097/00000478-198306000-00009.
Since 1976, we have discovered isolated, solitary nodules in seven spleens due to reactive lymphoid hyperplasia. Six cases were encountered at staging laparotomy for malignant lymphoma and one case was observed in a spleen resected because of autoimmune hemolytic anemia. Macroscopically, the nodules were strongly suggestive of splenic involvement by lymphoma; microscopically, however, splenic lymphoma was not demonstrated in any case. In four spleens, the nodules were formed by focal aggregation of reactive germinal centers. In three other cases, the nodules were manifestations of a localized proliferation of lymphocytes, including immunoblasts and plasma cells. The immunoblasts raised the question of splenic involvement by Hodgkin's disease, but Reed-Sternberg cells were not identified. The etiology of localized splenic lymphoid hyperplasia is unknown, but the lesion is likely analogous to florid reactive follicular and diffuse hyperplasia observed in a solitary enlarged lymph node stimulating malignant lymphoma.
自1976年以来，我们发现7例脾脏因反应性淋巴组织增生出现孤立性结节。6例是在恶性淋巴瘤分期剖腹探查时发现的，1例是在因自身免疫性溶血性贫血而切除的脾脏中观察到的。大体上，这些结节强烈提示脾脏受淋巴瘤侵犯；然而，显微镜检查显示所有病例均未证实有脾脏淋巴瘤。在4例脾脏中，结节由反应性生发中心的局灶性聚集形成。在另外3例中，结节是淋巴细胞包括免疫母细胞和浆细胞局限性增生的表现。免疫母细胞引发了脾脏是否受霍奇金病侵犯的疑问，但未发现里德-施特恩贝格细胞。局限性脾脏淋巴组织增生的病因不明，但该病变可能类似于在单个肿大淋巴结中观察到的刺激恶性淋巴瘤的旺盛反应性滤泡和弥漫性增生。
