猫抓病性淋巴结炎21例临床病理分析

Clinicopathological analysis of 21 cases of lymphadenitis in Cat-Scratch Disease(CSD)

目的 探讨猫抓病性淋巴结炎临床病理特点及诊断要点。方法 回顾性复习 2 1例猫抓病 (CSD)患者的临床资料 ,并对其淋巴结活检标本进行微波辐射 Warthin- Starry银染色 ,同时将其切片作常规 HE染色与抗酸杆菌染色 (Ziehl- Neelsen法 ) ,显微镜下观察。结果 Warthin- Starry染色经微波辐射处理后染色过程耗时仅约 15分钟 ,2 1例标本经改良 Warthin- Starry染色均显示淋巴窦区和微脓肿周围巨噬细胞胞浆内存在黑色、颗粒状、多形状的吞噬细胞 ;HE染色观察到特征性的微脓肿和肉芽肿形成 ;抗酸染色均阴性。结论 猫抓病性淋巴结炎具有微脓肿性肉芽肿形成的典型病理特征 ;微波辐射 Warthin- Starry银染色技术可在较短时间内清楚显示猫抓病性淋巴结病变中的病原体 ,对

Objective To investigate the clinicophatholgical characteristics and differential diagnosis of lymphadenitis in CSD.Methods Microwave eradiated Warthin Starry argentaion,compared with hematoxylin eosin stain and Ziehl Neelsen antacid stain,was performed on paraffin embedded tissue sections of lymph node biopsy specimens from 21 surgical pathology cases that contained CSD.Meanwhile,their clinical data were reviewed retrospectively.Results In all cases,modified Warhin Starry stains revealed the black,beaded and pleomorphic organisms around the lymphatic sinus and microabscess only approximately 15 minutes later,however,antacid stains for bacilli were negative.Histologically,HE staining showed the characteristic lesion of granulomatous microabscess.Conclusion CSD shows the characeteristics of microabcess.Microwave eradiated Warthin Starry silver stain,which can rapidly confirm and show the existence of pathogens in regional lymphadenits,possesses great applied value in the diagnosis and differentiation of CSD.