口腔颌面部嗜酸性淋巴肉芽肿的临床病理研究

Clinicopathology of Eosinophilic Lymphogranuloma in Oral and Maxillofacial Region

目的:探讨口腔颌面部嗜酸性淋巴肉芽肿(Kimura病)的临床病理学特征。方法:对武汉大学口腔医院诊治的28例口腔颌面部嗜酸性淋巴肉芽肿病例资料,分别从患者性别、发病年龄、临床表现、发病部位、实验室检查及组织病理学等方面进行回顾性分析。应用免疫组织化学方法行同种异体移植炎症因子(allograft inflammatory factor-1,AIF- 1)染色。28例患者中,男性19例,女性9例,中位年龄40岁。结果:此28例嗜酸性淋巴肉芽肿患者以腮腺区为多发部位。主要临床表现为皮下单发或多发性结节样肿块。外周血嗜酸性粒细胞计数平均为9%。组织病理学表现为淋巴组织增生并形成淋巴滤泡,内含活跃的生发中心。滤泡间可见大量增生的毛细血管后微静脉型血管;血管周围及滤泡间大量的嗜酸性粒细胞浸润并形成散在的嗜酸性微脓疡。免疫组织化学检测28例标本淋巴滤泡的生发中心AIF-1染色阳性。结论:嗜酸性淋巴肉芽肿是一种具有较明显临床及病理学特征的慢性炎症性疾病,免疫调节异常是其可能发病机制。

Objective： To investigate the clinicopathological features of eosinophilic lymphogranuloma（Kimura＇s disease） in oral and maxillofacial region. Methods： Data of 28 patients , were retrospectively reviewed. Biodata, clinical manifestation and parameters,especially serum eosinophil levels, histopathological characteristics were documented. Immunohistochemical analysis was performed in all specimens for allograft inflammatory factor-I （AIF-I）. There were 19 males and 9 females whose ages ranged from 13 to 66 years （mean 40 years） . The specimens presented mainly as a single or multiple subcutaneous nodule, most frequently in parotid gland region with lymphadenopathy in some cases. The average number of peripheral blood eosinophils was 9%. Results： Histopathological examination revealed lymphoid tissue hyperplasia formation of lymphoid follicles with active germinal centres and proliferation of post-capillary venules. There was diffuse infiltration of eosinophils in interfollicular and perivascular zones, sometimes forming eosinophilic microabscesses. Immunohistochemical staining demonstrated that the germinal center of lymphoid follicle was positive to AIF-1 antigen. Conclusion： Eosinophilic lymphogranuloma is a rare chronic inflammatory disorder with clinicopathologic features, of which dysimmunity may contribute to the pathogenesis.