Tsujino I, Oguma Y, Yamaguchi J
Fourth Department of Internal Medicine, Obihiro Kousei Hospital.
Rinsho Ketsueki. 1993 Aug;34(8):937-41.
A 40-year-old woman was admitted to our hospital because of fever, polyposia and polyuria in October 1990. The fasting blood sugar level was 471mg/dl and abdominal CT showed enlargement of the liver, kidneys, and intraabdominal lymph nodes. Although severe diabetes mellitus was controlled with insulin, intraabdominal lymph node swelling continued. Lymph node biopsy was performed under laparotomy. Four from intraabdominal lymph nodes, in addition to one from the left axillary lymph nodes. Four showed findings of non specific lymphadenitis, but one specimen obtained from near the right kidney demonstrated focal necrosis and invasion of macrophages and immunoblasts, which were compatible with the features of subacute necrotizing lymphadenitis (SANL). In SANL, lymphadenopathy is usually observed in the cervical region of young female and the involvement of intraabdominal lymph nodes is quite rare. This patient is the second case of SANL involving an intraabdominal lymph node reported in Japan, and it is suggested that SANL should be considered as a causative disorder of intraabdominal lymphadenopathy.
1990年10月，一名40岁女性因发热、多食及多尿入住我院。空腹血糖水平为471mg/dl，腹部CT显示肝脏、肾脏及腹腔内淋巴结肿大。尽管使用胰岛素控制了严重的糖尿病，但腹腔内淋巴结肿大仍持续存在。在剖腹手术中进行了淋巴结活检。除了取自左腋窝淋巴结的一个样本外，还从腹腔内淋巴结取了四个样本。四个样本显示为非特异性淋巴结炎，但从右肾附近获取的一个样本显示有局灶性坏死以及巨噬细胞和免疫母细胞浸润，这些表现与亚急性坏死性淋巴结炎（SANL）的特征相符。在SANL中，淋巴结病通常见于年轻女性的颈部区域，腹腔内淋巴结受累相当罕见。该患者是日本报道的第二例涉及腹腔内淋巴结的SANL病例，提示SANL应被视为腹腔内淋巴结病的病因之一。
