Tanizawa T, Eishi Y, Kamiyama R, Nakahara M, Abo Y, Sumita T, Kawano N
Department of Morphological Technology, Allied Health Sciences, School of Medicine, Tokyo Medical and Dental University, Japan.
Pathol Int. 1996 Oct;46(10):782-6. doi: 10.1111/j.1440-1827.1996.tb03549.x.
A case of reactive lymphoid hyperplasia of the liver exhibiting a characteristic angiofollicular pattern is reported. A hepatic nodular lesion was discovered by abdominal echography during clinical follow-up of abnormal liver function tests. It was diagnosed as hepatocellular carcinoma because of its hypervascularity when observed by angiography, and surgically resected. Grossly, the lesion was well-demarcated and measured 2 cm in diameter. Microscopically, the nodule was composed of lymph follicles with germinal centers, and the hyalinized inter-follicular space contained abundant hyalinized vasculature and plasma cells. The surrounding liver tissue exhibited chronic inflammation with some peculiar angiofollicular structures mimicking Castleman's disease. An immunohistochemical study revealed that the angiofollicular structure had the same characteristics as a lymph follicle with a germinal center, and that the plasma cells proliferating in the inter-follicular space had polyclonal immunophenotypes. These histological and immunohistochemical findings indicated that the angiofollicular structure observed was a kind of reactive lymph follicle, and that this hepatic lesion was reactive lymphoid hyperplasia rather than Castleman's disease or an inflammatory pseudotumor.
报告了一例表现为特征性血管滤泡模式的肝脏反应性淋巴组织增生病例。在对肝功能异常进行临床随访期间，腹部超声检查发现肝脏有一个结节性病变。由于血管造影显示其血管丰富，最初被诊断为肝细胞癌并接受了手术切除。大体上，病变边界清晰，直径为2厘米。显微镜下，结节由具有生发中心的淋巴滤泡组成，透明化的滤泡间间隙含有丰富的透明化血管和浆细胞。周围肝组织呈现慢性炎症，并伴有一些类似Castleman病的特殊血管滤泡结构。免疫组织化学研究显示，血管滤泡结构具有与带有生发中心的淋巴滤泡相同的特征，并且在滤泡间间隙增殖的浆细胞具有多克隆免疫表型。这些组织学和免疫组织化学结果表明，观察到的血管滤泡结构是一种反应性淋巴滤泡，并且该肝脏病变是反应性淋巴组织增生，而非Castleman病或炎性假瘤。
