Vayre-Oundjian L, Boruchowicz A, Bloget F, Triboulet J P, Gosselin B, Colombel J F
Service des Maladies de l'Appareil Digestif et de la Nutrition, Hôpital Cl.-Huriez, Lille.
Gastroenterol Clin Biol. 1997;21(12):990-3.
We report a case of pseudotumoral nodular lymphoid hyperplasia of the ileum in an immunocompetent 62-year-old woman. Ileoscopy showed multiple voluminous, soft, pliable, polypoid ileal lesions. Perendoscopic biopsies revealed a florid inflammation of the mucosa, characterised by numerous enlarged follicles with well-developed reactive germinal centres separated by a mixed infiltrate of lymphocytes, plasma cells and eosinophils. Immunohistochemistry showed a polytypic staining for kappa and lambda light-chains in the follicles and between and confirmed the reactive nature of the infiltrate. CT scan of the abdomen disclosed large periileal lymph nodes and a right ileocolectomy was performed. Twelve cases of pseudotumoral nodular lymphoid hyperplasia of the ileum have been reported in the literature in patients older than 25. In all cases, the diagnosis was performed after laparotomy. As shown in our case report, the diagnosis is possible on multiple perendoscopic biopsies.
我们报告一例62岁免疫功能正常女性的回肠假瘤样结节性淋巴组织增生病例。回肠镜检查显示多个体积较大、柔软、可弯曲的息肉样回肠病变。内镜下活检显示黏膜呈弥漫性炎症，其特征为大量增大的滤泡，伴有发育良好的反应性生发中心，其间有淋巴细胞、浆细胞和嗜酸性粒细胞混合浸润。免疫组化显示滤泡内及滤泡间kappa和lambda轻链呈多型性染色，证实了浸润的反应性本质。腹部CT扫描显示回肠周围有肿大淋巴结，遂行右半结肠切除术。文献报道了12例年龄大于25岁患者的回肠假瘤样结节性淋巴组织增生病例。所有病例均在剖腹手术后确诊。如我们的病例报告所示，通过多次内镜下活检即可确诊。
