坏死性淋巴结炎的临床病理及免疫组化分析

Analyses of clinical pathology and immunohistochemistry of necrotizing lymphadenitis

收集１９例坏死性淋巴结炎进行临床病理及免疫组化分析。女性多于男性，好发于青壮年，主要累及颈部浅表淋巴结伴发热，血沉加速，白血球总数偏低或正常；抗菌素治疗无效。组织学以显著的组织细胞增生伴大量细胞碎片的凝固性坏死、无嗜中性白细胞浸润为特征，并有显著纤维素样坏死性血管炎和出血。免疫组化证实病变中的多形核细胞和浆细胞样单核细胞为组织细胞。

Clinical and pathologic findings in 19 patients with necrotizing lymphadenitis are described. The incidence of the disease is higher in females than in males, young adults are frequently affected, superficial lymph nodes are primarily involved, especially the cervical lymph nodes, the disease is accompanied by fever, higher erythrocyte sedimentation rate and lower or normal white blood cell count and has poor response to antibiotics. Histologically, coagulative necrosis with marked histiocyte proliferation, large amounts of cellular debris, overt fibrinoid necrotizing vasculitis and hemorrhage, but without neutrophil infiltration are the characteristic findings. The immunohistochemical study has confirmed that the polymorphonuclear cells and plasmocytoid mononuclear cells are derived from histiocyte.