颈部猫抓病性淋巴结炎23例临床病理分析

Clinicopathological analysis of 23 cases of neck cat scratch disease lymphadenitis

目的：探讨颈部猫抓病性淋巴结炎的临床病理特征。方法选取驻马店市中医院2011年9月至2015年9月收治的23例颈部猫抓病性淋巴结炎患者，分析其临床病理特点。结果巨检：观察淋巴结，质量呈中等显示，为轻中度肿大，有灰黄色小的坏死灶于切面检出；镜下观察：以淋巴滤泡增生为主要表现，窦扩张，结构仍存在，有中性粒细胞间质浸润，有灶性或成片化脓性坏死，周边形成有肉芽组织。23例嗜银纤维染色结果均呈阳性，微脓肿周边、淋巴窦内切片示见颗粒状、棕黑色或多形性、杆状的细菌，均为显色阳性。采用手术切除肿大淋巴结，所有患者均痊愈。结论头颈部猫抓病淋巴结炎缺乏特异性临床表现，需依据病理特点及时诊断，对症支持并配合手术治疗可取得良好预后，最大程度保障患者生存质量。

Objective To investigate the clinical and pathological features of the neck cat scratch disease lymphadenitis. Methods From September 2011 to September 2015,23 patients with cat scratch disease were selected,the clinical and pathological features were analyzed. Results To observe the lymph nodes,the display quality was moderate,mild to moderate swelling,sallow little necrosis in section detection;microscope：the follicular hyperplasia as the main performance,sinus dilation structure was still there,neutrophils for interstitial infiltration with focal necrosis,or a piece of purulent surround-ing granulation tissue formation. Twenty-three cases addicted silver fiber staining results were positive, micro abscess surrounding lymph sinus see section showed granular,brown or pleomorphic,rod-shaped bacteria,both color positive. The group on the lymph nodes were removed by surgery,recovered. Con-clusions Head and neck cat scratch disease lymphadenitis lack of specific clinical manifestations,need to be diagnosed in time according to the pathological features,supportive treatment with surgery can a-chieve good prognosis,to ensure the quality of life of patients.