组织细胞坏死性淋巴结炎72例临床分析

Analysis of clinical characterstics of 72 patients with histiocytic necrotizing lymphadenitis

目的探讨组织细胞坏死性淋巴结炎的临床特点、病因病理及诊疗方法。方法回顾性分析72例组织细胞坏死性淋巴结炎的临床资料。结果本病多发于学龄期儿童和青年女性，可能与病毒感染有关，主要表现为淋巴结肿大，长期发热，白细胞下降，血沉增快，乳酸脱氢酶升高，淋巴结活检具有典型的组织病理学特点，抗生素治疗无效，消炎痛部分有效，激素有显效，本病具有自限性和复发性。结论病理及免疫组化检查是确诊组织细胞坏死性淋巴结炎的主要依据，此病预后良好，但部分具有复发性，应注意随访。

Objective To evaluate the clinical characteristics, etiology, pathology, diagnostic methods and treatment of histiocytic necrotizing lymphadenitis. Methods The materials of 72 patients with histiocytic necrotizing lymphadenitis were reviewed and analysed. Results This observation showed histiocytic necrotizing lymphadenitis was surveryed chiefly in school - aged children and young female and was related with virus infection. The clinical manifesation of this disease were lymph node enlargement, sustaining fever, lower white cell count,fast ESR , and higher activity of dehydrogenation of lactic acid. And lymph node of the patients were typical with histiocytic necrotizing lymphadenophathy. This disease was resistant to antibiotics ,but sensitive to Indomethacin partially,and hormone like cortisol had good effect on it. The disease was of self limiting and recurrent as well. Condusions The definite diagnosis of histiocytic necrotizing lymphadenitis depends on the results of pathological test and immunological check of lymph node. The disease is good in prognosis, but may recur for some patients. The patients should be fellowed up.