25例组织细胞坏死性淋巴结炎组织病理学观察

目的增加对组织细胞坏死性淋巴结炎病理学特征的认识,减少误诊、漏诊。方法结合文献对25例组织细胞坏死性淋巴结炎进行回顾性分析,分析临床病理资料及免疫组织化学标记。结果 25例病理组织学改变示淋巴结副皮质区有楔形、扇形或带状凝固性坏死灶,伴以增生、形态多样的组织细胞,吞噬现象明显,但无中性粒细胞及浆细胞浸润。免疫组化标记淋巴细胞以CD45RO阳性细胞及组织细胞、浆细胞样单核细胞表达CD68(+)。结论组织细胞坏死性淋巴结炎的临床病理特征复杂,确诊有赖于组织病理形态学特征。但易误诊为恶性淋巴瘤,应注意随访。     

Kikuchi病的临床病理特点(附10例报道)

目的 探讨Kikuchi病的临床病理特点，为病理诊断和鉴别诊断提供依据。方法 回顾性分析10例Kikuchi病的临床资料，全部病例重新切片进行组织学观察，并行免疫组化染色，随访全部病例。结果 10例中女性7例，男性3例，年龄14～42岁，平均年龄25岁。临床主要表现为发热，颈淋巴结肿大和白细胞减少，抗生素治疗无效。组织学显示淋巴结内出现程度不同的碎片状坏死，伴有多种形态的组织细胞增生；病变区及周围有免疫母细胞和浆样单核细胞增多，无中性白细胞浸润。组织细胞Mac-387和Lysozyrne( )，大多数淋巴细胞CD3和CD45RO( )；滤泡生发中心及散在的少数淋巴细胞DC20( )。随访4个月～7年，全部存活。结论 Kikuchi病是一种具有特殊临床表现和独特病理特点的淋巴结炎性病变，预后良好。掌握其临床和病理形态学特点，有助于其他病变相鉴别。     

儿童组织细胞坏死性淋巴结炎46例临床分析

组织细胞坏死性淋巴结炎（HNL）又称亚急性坏死性淋巴结炎、坏死性增生性淋巴结病。由日本人Fikuchi和Fujimono于1972年首次描诉,因此又称Fikuchi病或Fikucbi-Fujimono病,是一种少见的原因不明的非肿瘤性淋巴结炎性疾病,临床主要特征为顽固性发热、浅表淋巴结肿大。淋巴结活检为主要诊断手段。本病误诊率高,激素有特效,故提高对其认识和诊断水平有重要临床意义。我院于2000年1月～2008年12月经淋巴结活检确诊的组织细胞坏死性淋巴结炎46例报告如下。     

儿童颈部淋巴结肿大临床病理分析

[目的]探讨本地区儿童颈部淋巴结肿大的临床和病理特点.[方法]对500例儿童颈部淋巴结肿大病例的临床和病理进行观察与分析,部分病例作了免疫组化染色.[结果]儿童颈部淋巴结肿大原因主要为非特异性淋巴结炎,其次为淋巴结结核和猫抓病,再次为其他疾病.[结论]儿童颈部淋巴结肿大应及时就诊.对病因不明病例,病理活检是确诊的主要手段.     

组织细胞性坏死性淋巴结炎5例临床分析

目的探讨组织细胞性坏死性淋巴结炎的临床特点及诊治结果，减少误诊。方法对5例组织细胞性坏死性淋巴结炎临床资料进行回顾性分析。结果5例患者，其中男性1例，女性4例，年龄15-36岁，平均22岁。临床以发热、淋巴结肿大、白细胞减少为主要表现。对糖皮质激素药物治疗反应良好。结论组织细胞性坏死性淋巴结炎临床表现缺乏特异性，确诊需依靠淋巴结病理活检。治疗结果呈自限性，预后良好。     

儿童亚急性坏死性淋巴结炎8例分析

目的：探讨儿童亚急性坏死性淋巴结炎（SNL）临床特征及诊治结果。方法：对8例SNL患儿进行回顾分析。结果：8例儿童SNL临床表现均有淋巴结肿大，发热和白细胞减少为主要临床表现，8例中曾有4例误诊，误诊率50.0％，需与淋巴结结核、恶性淋巴瘤、传染性单核细胞增多症等鉴别。结论：激素活疗有效，预后良好。     

高频及彩色多普勒超声在颈部浅表淋巴结病变诊断中的应用

我院超声科自2000年9月-2002年12月使用高分辨率探头,配合彩色多普勒超声检查各种颈部浅表淋巴结肿大患者101例,现将其检查结果进行对比分析。1资料与方法全部病例均为本院门诊和住院患者,年龄2～73岁,男63例,女38例,其中已经过病理组织学证实为淋巴瘤18例,淋巴结转移癌23例,淋巴结结核3例,淋巴结炎10例,经过内科治疗临床观察证实淋巴结炎47例。方法:使用GEVOLUSON700彩色多普勒超声诊断仪,探头频率7.5-10.0MHz,对肿大淋巴结作全面扫查,观察其形态、大小、内部回声及与周围组织关系,然后采用CDFI和     

206例周围淋巴结结核的临床分析

２０６例周围淋巴结结核的临床分析上海市徐汇区结核病防治所２０００３１诸葛芳结核性淋巴结炎是由于结核菌侵入淋巴结所引起的慢性炎症，其特点是病程长、易于复发。本文就我所１９８７年１月到１９９３年６月经淋巴结穿刺或活检病理确诊为结核性淋巴结炎的２０６例病例...     

组织细胞性坏死性淋巴结炎的诊断与治疗

组织细胞性坏死性淋巴结炎 (ｈｉｓｔｉｏｃｙｔｉｃｎｅｃｒｏｔｉｚｉｎｇｌｙｍ ｐｈａｄｅｒｉｔｉｓ,Ｋｉｋｕｃｈｉｄｉｓｅａｓｅ ,ＨＮＬ)是一种特殊类型的非肿瘤性淋巴结疾病。本病多发于儿童及青壮年 ,临床呈亚急性经过 ,持续性发热 ,应用抗生素无效 ,淋巴结肿大和白细胞不升高或轻度减少为特点。由于本病发病率较低且具有自愈性 ,在临床上没有引起足够的重视 ,很容易被误诊。1　材料与方法本组共搜集ＨＮＬ 12例 ,其中男 5例 ,女 7例 ,年龄 11～38岁 ,平均年龄 2 3岁。发病前均为咽痛及上呼吸道感染表现或以发热为首发症状。临床…     

上颌窦出血坏死性息肉18例临床诊疗分析

目的：探讨上颌窦出血坏死性息肉的临床诊治方法及效果。方法：对18例上颌窦出血坏死性息肉的临床资料,包括临床表现、CT特征性表现、手术方式的选择及结果等进行回顾性分析。结果：所有患者均在鼻内镜下经鼻或双径路手术彻底清除病灶,术后病理报告为出血坏死性息肉或慢性炎症伴出血坏死组织,1例病检发现真菌菌丝和菌孢。18例患者均治愈,术后恢复良好,无并发症。随访1.5~5年,全部病例均无复发,症状消失。结论：上颌窦出血坏死性息肉有其CT特点,可在鼻内镜下经鼻或双径路手术彻底切除,具微创化特点。     

Screening tests for diagnosis of cervical lymphadenopathy presenting as prolonged fever

During a two years period, 16 cases having cervical lymphadenopathy presenting as prolonged fever were studied in Abbassia fever hospital, Cairo, Egypt. Patients were subjected to careful history, thorough clinical examination, complete blood picture, tuberculin test, chest x-ray, Monospot test, indirect fluorescent antibody test for toxoplasmosis, detection of cytomegalovirus antibodies and lymph node biopsy with histopathological examination. Ten within normal subjects were taken as controls. The patients were grouped on histopathological basis into 5 groups: (1) One (6%) of the cases was non-specific lymphadenitis diagnosed by clinical examination of the scalp and leucocytosis with polymorphonuclear predominance. (2) Reactive lymphadenitis included 6 (38%) of the cases. Infectious mononucleosis cases were diagnosed by clinical triad of fever, pharyngitis and cervical lymphadenopathy, relative lymphocytosis, monocytosis and positive monospot test. Cytomegalovirus case was diagnosed by lymphocytosis, monocytosis and negative monospot test. Toxoplasmosis cases were diagnosed by monocytosis, negative tuberculin test and positive indirect fluorescent antibody test. (3) Granulomatous lymphadenitis comprised 6 (3%) of the cases. Tuberculous cases were diagnosed by high ESR and highly positive tuberculin test. Sarcoidosis cases were diagnosed by negative tuberculin test and presence of hilar lymphadenopathy. (4) Non-Hodgkin lymphoma case (6%) was diagnosed by clinical deterioration and total lymph node biopsy. 15) Systemic infections were diagnosed by clinical examination, blood culture for salmonellae and brucellae, Widal and Brucella agglutination tests. It is concluded from this study that screening tests are important aids in the diagnosis of cases of cervical lymphadenopathy presenting by prolonged fever especially if lymph node biopsy and histopathological examination are not available or contraindicated. Tub     

Histopathological Characterization of Cases of Spontaneous Fatal Feline Severe Fever with Thrombocytopenia Syndrome,Japan

Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tickborne infectious disease caused by SFTS virus (SFTSV). We report 7 cases of spontaneous fatal SFTS in felines. Necropsies revealed characteristic lesions, including necrotizing lymphadenitis in 5 cases and necrotizing splenitis and SFTSV-positive blastic lymphocytes in all cases. We detected hemorrhagic lesions in the gastrointestinal tract in 6 cases and lungs in 3 cases, suggesting a more severe clinical course of SFTS in felids than in humans. We noted necrotic or ulcerative foci in the gastrointestinal tract in 3 cases, the lung in 2 cases, and the liver in 4 cases. We clarified that blastic lymphocytes are predominant targets of SFTSV and involved in induction of necrotic foci. We also found that thymic epithelial cells were additional targets of SFTSV. These results provide insights for diagnosing feline SFTS during pathological examination and demonstrate the similarity of feline and human SFTS cases.     

组织细胞坏死性淋巴结炎诊断与治疗

目的探讨组织细胞坏死性淋巴结炎(histiocytic necrotizing lymphadenitis,HNL)的诊断和治疗。方法对我院从1996～2005年共收治的HNL38例的临床表现,检查和诊断,以及治疗和愈后进行回顾性分析。结果所有患者通过淋巴结病理活检确诊,经肾上腺皮质激素治疗后愈后良好。结论活检术在HNL诊断方面具有重要的临床价值,肾上腺皮质激素在治疗HNL方面疗效满意。     

Histiocytic necrotizing lymphadenitis; Kikuchi's disease

The case is reported of a woman aged 26 with painful swelling of the left cervical lymph nodes. These symptoms were preceded by paresthesias and pain at the left side of her body, especially the left leg and the left arm. A lymph node biopsy revealed the diagnosis of histiocytic necrotizing lymphadenitis (Kikuchi's disease). Physical examination and laboratory data showed no other abnormalities. The patient recovered soon without any therapy. The morphological findings are described and a review of the literature is given.     

Place de la ponction à l’aiguille fine du ganglion lymphatique dans le diagnostic d’adénopathies mycobactériennes au Mali

Objective: The relative lack of well-equipped pathology laboratories in areas of high tuberculosis prevalence can result in delayed or misdiagnosis of mycobacterial lymphadenitis. The aim of our study was to define the suitability of fine needle aspiration from lymph node to diagnose mycobacterial lymphadenitis in adults.Population: From June 1997 to April 1999, 51 patients with the diagnosis of mycobacterial lymphadenitis were admitted to two medical units in Bamako (Mali).Results: Ziehl–Neelsen staining was positive in 29 cases and 61.9% of these correlated to cytology results. Acid-fast bacilli were more frequent in lymph node aspiration than in sputum. Lymph node cytology and bacilloscopy were three to six times faster and cheaper than histology.Conclusion: Fine needle aspiration should be performed systematically for bacilloscopy and cytology in any adult with lymphadenitis in countries where HIV and tuberculosis are common.     

高频彩色多普勒在小儿肠系膜淋巴结炎诊断中的应用

目的探讨高频彩色多普勒在小儿肠系膜淋巴结炎诊断中的应用价值。方法选择101例肠系膜淋巴结炎患儿(观察组)和100例健康体检儿童(正常组),使用PHILIPS-IU22彩色超声诊断仪检查,比较两组检出淋巴结分布、大小,并观察组淋巴结回声性质。结果观察组检测出淋巴结位于右下腹和脐周者多于正常组(p<0.05),观察组淋巴结横径为(6.6±1.4)mm,纵径为(14.1±5.0)mm,观察组低回声型73例,等回声型20例,混合回声型8例。结论高频彩色多普勒是诊断小儿肠系膜淋巴结炎的首选检查方法,对临床诊断治疗有重要意义。     

Management and outcome of Bacille Calmette-Guérin vaccine adverse reactions

BackgroundBacille Calmette-Guérin (BCG) vaccine is one of the most widely used vaccines globally. Management of local BCG complications (injection site reactions and suppurative or non-suppurative lymphadenitis) varies between clinicians, and the optimal approach remains uncertain.AimTo determine the clinical features, management and outcome of BCG complications at two large acute hospitals in London, United Kingdom.MethodsAll children presenting with complications of BCG vaccination between January 2008 and December 2013 were included in this observational study. Medical and electronic laboratory records were reviewed to determine clinical features, treatment and outcome.ResultsSixty children presented with adverse reactions. Two-thirds (65%) presented with BCG lymphadenitis, one-third (30%) presented with injection site complications and two children (3%) presented with both injection site reaction and lymphadenitis; only one child (2%) had disseminated BCG disease. The majority (88%) of children with injection site reactions were managed conservatively; overall, 95% showed complete resolution within 6 months. Among children with lymphadenitis, 46% were managed conservatively, whilst 54% had anti-tuberculous therapy and/or a procedure (aspiration mostly, or surgery); complete resolution was seen in 59% of cases.ConclusionsInjection site reactions and non-suppurative lymphadenitis were generally managed conservatively, with good outcomes. There was more variation in management and outcome of suppurative lymphadenitis and the optimal approach remains uncertain.     

Cellulitis incidence in a defined population

A population-based insurance claims database was used to examine cellulitis incidence, anatomical sites of infection, complicating diagnoses, source of health service, and recurrence rates. Insurance claim files were searched for cellulitis ICD-9-CM codes 681.0-682.9. Complications of cellulitis including erysipelas, lymphadenitis, lymphangitis, and necrotizing fasciitis were also identified by ICD-9-CM codes. We found a cellulitis incidence rate of 24.6/1000 person-years, with a higher incidence among males and individuals aged 45-64 years. The most common site of infection was the lower extremity (39.9%). The majority of patients were seen in an outpatient setting (73.8%), and most (82.0%) had only one episode of cellulitis during the 5-year period studied. There was a very low incidence of cellulitis complications, including necrotizing fasciitis. Cellulitis is fairly common, usually treated in outpatient settings, and is infrequently complicated by erysipelas, lymphadenitis, lymphangitis, or necrotizing fasciitis.     

Lymphadénite axillaire à Corynebacterium pseudotuberculosis chez une patiente de 63 ans

A 63-year-old woman living in a rural area presented in 2004 with a granulomatous necrotizing axillary lymphadenitis caused by Corynebacterium pseudotuberculosis, a Gram positive bacillus belonging to the group of Corynebacterium diphtheriae, which is found primarily in animal infections. In the human being, around 30 cases of infection due to C. pseudotuberculosis have been described, mainly among people working in contact with infected animals. For this reason, this infection, which induces exclusively lymphadenitis and abscesses with granulomatous necrotizing lesions, should be regarded as an occupational disease. In this patient, due to ignorance of the disease, this bacterium was considered to be merely saprophytic. The first treatment introduced was probabilistic antibiotherapy followed by a second course of antibiotics after aspiration. The trend confirmed that this was not the correct treatment and that surgery was the only way to achieve a cure.     

Six cases of suppurative lymphadenitis caused by Burkholderia pseudomallei infection

Melioidosis, an infection caused by Burkholderia pseudomallei, is endemic in Southeast Asia and northern Australia. It can have various presentations, ranging from acute septicaemia to chronic localized infection. Uncomplicated, localized infection usually involves skin or subcutaneous tissues. Suppurative lymphadenitis caused by melioidosis has been rarely encountered by clinicians practicing in endemic areas. We encountered six cases of suppurative lymphadenitis caused by Burkholderia pseudomallei in adults who were admitted to hospital in Singapore from 1997 to 2000. The most striking difference between these patients and cases reported previously was the pattern of the lymph node involvement. In the majority of previously described patients the infected lymph nodes were in the head and neck region. By contrast, four patients in our study presented with unilateral, inguinal lymphadenitis. Another two patients presented with mediastinal lymphadenitis and prolonged fever. All patients had prompt and sustained response to therapy. Melioidosis should be considered in the differential diagnosis of suppurative, regional lymphadenitis, especially in patients who travelled to, or stayed in, an endemic area.