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49例坏死性淋巴结炎的临床病理及免疫组化研究

[A clinicopathological and immunohistochemical study of 49 cases of necrotizing lymphadenitis].

作者信息

Zhang S, Liu W, Li G, Xu S, Bu H, Qin Z, Li F, Lei L

机构信息

Department of Pathology, First Affiliated Hospital.

出版信息

Hua Xi Yi Ke Da Xue Xue Bao. 1993 Mar;24(1):23-6.

PMID:8340086
Abstract

A clinicopathological and immunohistiochemical study of 49 cases of necrotizing lymphadenitis was made. Twenty-four patients were male and twenty-five female with the M:F ratio of 0.96:1. The patients ranged in age from 9 to 62 years with a mean of 26. Forty-nine patients had superficial lymphadenopathy, and twenty-two were accompanied by fever. The results also showed that there was multifoci necrosis present in the involved lymph nodes, particularly in the cortex or/and paracortex, with variable numbers of small lymphocytes, immunoblasts, histocytes and phagocytes, the latter with phagocytized nuclear debris derived from necrotizing T lymphocytes. However, granulocytes and plasmacytes were generally absent, and B lymphocytes rare. The pathogenesis of this disease remains unknown and the pathogen has not been found by Gram, Giemsa, PAS, Ziehl-Neelsen and Warthin-Starry stain. The diagnosis, differential diagnosis and etiology of this disease are discussed. We support the suggestion that this entity be called "Kikuchi-Fujimoto's disease" rather than "Histiocytic necrotizing lymphadenitis".

摘要

对49例坏死性淋巴结炎进行了临床病理及免疫组织化学研究。患者中男性24例,女性25例,男女比例为0.96:1。患者年龄9至62岁,平均年龄26岁。49例患者均有浅表淋巴结肿大,22例伴有发热。结果还显示,受累淋巴结存在多灶性坏死,尤其在皮质或/和副皮质区,有数量不等的小淋巴细胞、免疫母细胞、组织细胞及吞噬细胞,后者吞噬有坏死性T淋巴细胞来源的核碎片。然而,通常无粒细胞及浆细胞,B淋巴细胞少见。本病的发病机制尚不清楚,革兰氏、吉姆萨、PAS、齐-尼及沃-斯染色均未发现病原体。对本病的诊断、鉴别诊断及病因进行了讨论。我们支持将本病称为“菊池-藤本病”而非“组织细胞坏死性淋巴结炎”的建议。

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