组织细胞坏死性淋巴结炎29例临床病理分析

Clinicopathological analysis of 29 cases of histiocytic necrotizing lymphadenitis

目的:探讨组织细胞坏死性淋巴结炎(HNL)的临床病理特征。方法:回顾性分析29例HNL的临床资料,观察描述其病理特征;用S-P免疫组化法检测细胞表型。结果:HNL多见于年轻女性,颈部淋巴结肿大,高热,外周血WBC降低。活检标本常呈破碎状,淋巴结皮质、副皮质区可见片状或融合的凝固性坏死灶,坏死灶内可见嗜碱性核碎片和嗜酸性颗粒碎屑,伴有T细胞和组织细胞的大量增生,无中性粒细胞浸润,B细胞少量散在分布。结论:淋巴结肿大、高热,淋巴结内不伴有中性粒细胞浸润的散在或片状凝固性坏死及大量组织细胞增生为HNL的临床病理特征。

Objective： To explore the clinicopathological characteristics of histiocytic necrotizing lymphadenitis （HNL）. Methods： We retrospectively reviewed 29 cases of HNL The pathological characteristics were recorded, and the cellular phenotype was determined by imamunohistochemical S-P method. Results： HNL primarily affected young women, who presented cervical lymph node swelling, high fever, and decrease of white blood cell in peripheral blood. The gross appearance of the tissue in biopsy was fragmental. Patchy or confluent coagulation necrosis was found in the cortex and paracortex of lymph nodes. The necrotic focus consisted of basophilic karyorrhectic fragments and eosinophilic granular debris which was accompanied by the proliferation of T - lyinphocytes and histiocytes and sparse distribution of B-lymphocytes. No neutrophil infiltration was found in the necrotic focus. Conclusion： HNL can be correctly diagnosed on the basis of the clinicopathological and immunohistoeherrdcal characteristics.