Sadahira Y, Yoshimoto S, Manabe T
Department of Pathology, Kawasaki Medical School, Kurashiki, Japan.
Pathol Int. 1998 Oct;48(10):829-33. doi: 10.1111/j.1440-1827.1998.tb03845.x.
There have been few reports on lymph node swelling in human parvovirus (HPV) B19 infection. A report of a 42-year-old female, who developed HPV B19-associated transient red cell aplasia with lymphadenopathy, is presented. The lymph node swelling began with the appearance of atypical lymphocytes in the peripheral blood and it disappeared as the patient recovered from the aplasia. Microscopically, the patient's bone marrow showed characteristic giant proerythroblasts with no maturation of the erythroid series. An excised inguinal lymph node showed florid, reactive follicular hyperplasia with paracortex expansion, and neutrophil infiltration and hemophagocytosis in the medullary sinus. These findings were compatible with the histology of a viral infection. A polymerase chain reaction study revealed HPV B19 in her serum and lymph node, but an immunohistochemical study failed to demonstrate HPV B19 capsid antigen in the lymph node or bone marrow. Although the present case suggests that reactive lymphadenopathy is associated with HPV B19 infection, the mechanism of the lymph node swelling still remains to be elucidated.
关于人类细小病毒（HPV）B19感染导致淋巴结肿大的报道较少。本文报告了一名42岁女性，其患HPV B19相关的短暂性红细胞再生障碍并伴有淋巴结病。淋巴结肿大始于外周血中出现非典型淋巴细胞，并随着患者从再生障碍中恢复而消失。显微镜下，患者骨髓显示出特征性的巨大早幼红细胞，红系无成熟现象。切除的腹股沟淋巴结显示出活跃的反应性滤泡增生伴副皮质区扩张，以及髓窦中的中性粒细胞浸润和噬血细胞现象。这些发现与病毒感染的组织学表现相符。聚合酶链反应研究在她的血清和淋巴结中检测到HPV B19，但免疫组织化学研究未能在淋巴结或骨髓中显示HPV B19衣壳抗原。尽管本病例提示反应性淋巴结病与HPV B19感染有关，但淋巴结肿大的机制仍有待阐明。
