增生性Kikuchi淋巴结炎与恶性淋巴瘤的鉴别诊断

Differential diagnosis between the proliferative Kikuchi lymphadenitis and malignant lymphoma

目的 :探讨增生性Kikuchi淋巴结炎与恶性淋巴瘤的鉴别诊断要点。方法 :收集 7例诊断疑难的Kikuchi淋巴结炎病例进行组织学和免疫组织化学观察。结果 :本病的共特点是 :①先发热后淋巴结肿大、有自限性 ;②病变为多灶性。由以新生组织细胞和吞噬细胞为主混有少量浆细胞样单核细胞、T免疫母细胞及T小淋巴细胞多细胞组成 ,有核碎片散在 ;③缺乏中性白细胞浸润 ;④核分裂易见。结论 :作者认为本病的特殊病史 ,病变多灶性 。

Purpose:The study of major point on differential diagnosis between the Kikuchi lymphadenitis and malignant lymphoma.Methods:7 cases difficult diagnosis of Kikuchi lymphadenitis were observed by histology and immunohistochemistry.Results:The common features in these 7 cases kikuchi lymphadenitis was (1) The lymphnode swelling after heat;(2)Multiple focus of lesion and in the pathologic areas, the cellular composition was dominated by striking blastic histiocytes and phagocytes, few plasmacytoid monocytes, T immunoblasts and T lymphocytes;(3) Absence of neutrophiles infiltration;(5)Variable amounts of mitotic figures. Conclusions:Author considered on the special clinical feature, multiple focus of leison, striking blastic histiocytes and phagocytes and few other cells mixed composition, and with variable amount of nuclear debris were major features of differential diagnosis between the Kikuchi lymphadenitis and malignant lymphoma.