面颈部血管滤泡性淋巴结增生临床病理研究

Clinical and Pathological Study of Angiofollicular Lymphonode Hyperplasia in the Head and Neck

目的:结合文献复习,研究面颈部血管滤泡性淋巴结增生(AFH)的临床表现、病理形态特征。方法:报道了3例该病变,并进行临床、病理及免疫组化等回顾性分析。结果:临床分型主要有局灶型及多中心型2类,组织学分型主要有透明血管型、浆细胞型2型。本文3例均为局限性肿块、透明血管型,手术切除预后较好。文献指出,AFH是一种交界性的淋巴组织增生性病变,局灶型肿块为良性,而多中心型常为恶性结局。结论:手术切除肿大淋巴结是治疗本病的主要方法。单中心型多可通过手术达到治愈的目的,多中心型手术切除后有复发可能,需结合放疗化疗等治疗方法。对于多中心型AFH其生物学行为及治疗预后,还有待于进一步研究探讨。对于淋巴组织增生性病变,鉴别诊断免疫组化尤为重要。

Objective： To study the clinical and pathological features of angiofollicular lymphonode hyperplasia （AFH） with the literature reviewed. Methods： Report three cases of this lesion with their clinical and histologic fea- tures analyzed retrospectively. Results.. The two primary clinical presentations are localized type and multicentric type. The bistopathological presentation can be differentiated into a hyaline vascular variant, a plasma cell variant. The three cases here are unicentric, benign and belong to hyaline vascular variant, the prognosis of which is good after surgical resection. But some works point out that AFH is a borderline hyperplastic lymphopathy. Unicentric type is benign and multicentric type will maybe come to malignancy. Conclusion： Surgery remains the main treatment. The localized type can be cured by surgical resection while the multicentric type with the possibility of recurrence should be treated using surgical method combined with chemical therapy. We should pay much attention to AFH just because of its specialties, give suggestions to the clinic and collect cases to focus on its biological behavior, treatments and prognosis especially to the multicentric type in lymph nodes for further research. When meeting dif- ficulties during our pathological diagnoses, we can distinguish it from other lesions such as malignant lymphoma by using immunohistochemistry.