组织细胞性坏死性淋巴结炎的临床分析

Clinical analysis of histocytic necrotizing lymphadenitis

目的:了解组织细胞性坏死性淋巴结炎的临床特点及组织病理学改变,提高对该病的认识。方法:回顾性分析10例组织细胞性坏死性淋巴结炎的临床特点、组织病理学改变、临床诊断体会。结果:10例患者临床特点包括:发病以青年女性为主,以淋巴结肿大和发热最常见;少数病例与结缔组织病伴发;淋巴结组织病理学改变为被膜及皮质浅层多灶性坏死,不同程度的组织细胞增生,无中性粒细胞浸润。结论:组织细胞性坏死性淋巴结炎具有较典型的淋巴结组织病理学改变,临床上易与淋巴瘤、淋巴结结核相混淆,并有与其他疾病伴存现象,该病预后相对良好。

Objective To understand the clinical features and histopathology of histocytic necrotizing lymphadenitis （HNL） so as to better recognize the disease. Methods The clinical features, histopathology, and diagnosis of 10 patients admitted to our hospital were retrospectively analyzed. Results The clinical features of these 10 cases included： young females were the majority; lymphadenopathy and fever were the most common clinical manifestations; some cases were accompanied by connective tissue diseases. Histopathologic examination showed distinctive necrosis and around the necrotic loci, variable proliferations of histocytes but generally without infiltration of neutrophils. Conclusion HNL has some typical histopathological alterations and relatively fine prognosis, but it tends to be misdiagnosed as lymphoma or lymphoid tuberculosis and may be accompanied by other diseases.