Schapers R F, Reif R, Lennert K, Knapp W
Virchows Arch A Pathol Anat Histol. 1981;390(2):127-38. doi: 10.1007/BF02215979.
The histopathological diagnosis of Yersinia enterocolitica infections in mesenteric lymph nodes is described on the basis of biopsy material from 14 cases collected at the Lymph Node Registry in Kiel. In all cases, the aetiological diagnosis was verified by demonstrating significant antibody titres in serological tests and, in two cases, by isolating Yersinia enterocolitica from faeces. The mesenteric lymph nodes showed a rather specific histological picture. In all cases, the capsule was thickened by oedema and stained metachromatically. The cortical and paracortical pulp was always hyperplastic owing to an increase in the number of immunoblasts, plasmablasts, and plasma cells. The sinuses were dilated and filled with intensely basophilic cells that varied in size from small to large (plasmacytoid cells and precursors). Small, or relatively large accumulations of "immature histiocytes" (transformed lymphocytes) were seen in the sinuses in about two thirds of the cases. Occasionally, there were small foci of small histiocytes (emigrated monocytes) in the cortical pulp. An abscess similar to the abscesses found in abscess-forming reticulocytic lymphadenitis due to Yersinia pseudotuberculosis was evident in only one case. The differential diagnosis is also discussed. The diseases to be considered are mesenteric lymphadenitis due to Yersinia pseudotuberculosis or salmonella infection, and nonspecific mesenteric lymphadenitis.
基于在基尔淋巴结登记处收集的14例活检材料，描述了肠系膜淋巴结耶尔森氏小肠结肠炎感染的组织病理学诊断。在所有病例中，通过血清学检测显示出显著的抗体滴度来验证病因诊断，在两例病例中，通过从粪便中分离出耶尔森氏小肠结肠炎来验证。肠系膜淋巴结呈现出相当特异的组织学图像。在所有病例中，包膜因水肿而增厚并呈异染性染色。由于免疫母细胞、成浆细胞和浆细胞数量增加，皮质和副皮质髓质总是增生的。窦扩张并充满了大小不一的强嗜碱性细胞（浆细胞样细胞和前体细胞）。在大约三分之二的病例中，在窦中可见小的或相对大的“未成熟组织细胞”（转化淋巴细胞）聚集。偶尔，在皮质髓质中有小的小组织细胞（游走单核细胞）灶。仅在一例病例中可见类似于由假结核耶尔森氏菌引起的形成脓肿的网状细胞性淋巴结炎中发现的脓肿。还讨论了鉴别诊断。需要考虑的疾病有假结核耶尔森氏菌或沙门氏菌感染引起的肠系膜淋巴结炎，以及非特异性肠系膜淋巴结炎。
