组织细胞性坏死性淋巴结炎的临床病理学研究及其与恶性淋巴瘤的鉴别（附31例报告）

THE CLINICOPATHOLOGIC STUDY OF HISTIOCYTIC NECROTIZING LYMPHADENITIS AND THE DIFFERENTIATED DIAGNOSIS WITH MALIGNANT LYMPHOMA 一Report of 31 Cases

组织细胞性坏死性淋巴结炎（ＨＮＬ）为一种少见的良性疾病。好发于年轻妇女的颈部，引起淋巴结肿大，并常伴有发热及其它全身症状，形成独具一格的临床病理过程。因其组织像具有一定的谱系变化，故对其不熟悉者易造成误诊。据文献记载误诊率竟高达３０％～４０％，特别是在其早期增殖阶段尤甚。作者通过对３１例ＨＮＬ的分析，不仅系统总结了本病的临床病理特征，而且着重阐述了其与淋巴瘤的鉴别要点。尽管目前认为本病属于自限性的良性过程，但在本组病例中也确有２例为系统性红斑狼疮患者，提示两者间可能有某种内在的联系，值得今后进一步探索，包括进行长期随访及了解病人的转归。

Abstract Histiocytic necrotizing lymphadenitis(HNL) is a kind of rare benign disease, predilection toinvolve the neck of young women ,causing enlargment of the lymph nodes and usually accompaning by fever and other constitutional symptoms ,and a unique clinicopathologic course are characteristic of this disease. Because its histomorphology has a given spectrum changing ,it may lead to misdiagnosis for someone who is unfamiliar with it. According to the document records,misdiagnostic of HNL could be up to 30%～40%,especially in its early proliferative stage. In this 31 cases analysis ,the authors systematically summarize the clinicopathologic characteristics of this lesion ,and focus to elucidate the different features between HNL and lymphoma. Althoughpresently it is thought that the disease is self-limited, there are two cases with clinical manifestations of systemic lupus erythematosus in our series. Possibly ,the two diseases may have some intrinsicrelationships. Long term follow- up of its final outcome in these patients is nacessary to clarify whether or not HNL is a self- limiting or progressive disease.