组织细胞性坏死性淋巴结炎的临床病理分析

Histocytic necrotizing lymphadenitis：a clinicopathological analysis

目的探讨组织细胞性坏死性淋巴结炎（HNL）的临床病理特征。方法复习10例HNL淋巴结活检标本的HE切片，并用免疫组化sP法检测病灶内细胞的免疫表型。结果HNL组织学上副皮质区，尤其是滤泡间区有散在大小不等或融合病灶，由多种形态的组织细胞、转化的淋巴细胞和凋亡碎屑构成，缺乏中性粒细胞、浆细胞和（或）嗜酸性粒细胞反应。部分淋巴细胞表达CD45RO，组织细胞表达CD68，残留的生发中心细胞表达CD20。结论淋巴结活检显示有多种组织细胞、转化T细胞以及凋亡碎片组成的病灶，不合并有粒细胞浸润，有利于HNL的诊断。

Objective To describe the clinicopathological features of histiocytic necrotizing lymphadenitis（HNL）. Methods Routine lymph node biopsies of 10 HNL cases were reviewed and their immunophenotyping were performed using S-P immunohistochemical staining. Results Histologically, HNL had discrete or integrated nodules variable in size in the paracortex, expecially in the interfollicular area,which were full of proliferating pleomorphic histocytes, transformed lymphocytes, and karyorrhectic debris without infiltration of the neutrophils, plasma cells and/or eosinophils. Immunohistochemistry revealed CIM5RO ＋ for transformed lymphocytes, CD68 ＋ for histiocytes, and CD20 ＋ for lymphocytes in the residual germinal centers. Conclusion The presence of pleomorphic histiocytes, transformed T-cells, and karyor-rhectic debris in the biopsy of lymph nodes, together with the absence of neutrophils support the diagnosis of HNL.