组织细胞坏死性淋巴结炎52例临床病理表现

目的探讨组织细胞坏死性淋巴结炎的临床和病理学特点。方法回顾性分析52例组织细胞坏死性淋巴结炎的临床表现、淋巴结活检病理学特点及其诊治。结果52例患者中女性41例（79％）,主要表现为持续发热（100％）,单发（23％）或多发（77％）淋巴结肿大（以颈部多见）,多形性皮疹（35％）,外周血白细胞计数降低（76％）,血沉增快（100％）,抗生素治疗无效（100％）,小剂量肾上腺糖皮质激素治疗有效（81％）等。26例患者（50％）肝酶升高,仅7例（13％）伴流感样上呼吸道症状。淋巴结活检病理学特点为不同程度的凝固性坏死伴多种形态的组织细胞、淋巴细胞浸润,无中性粒细胞浸润。免疫组化染色示组织细胞CD68及T细胞CD3、CD45,RO阳性,CD15、CD20及CD30均阴性。结论组织细胞坏死性淋巴结炎的临床表现无特异性,较易误诊,确诊主要依靠病理活检及免疫组化检查。     

组织细胞坏死性淋巴结炎32例临床分析

组织细胞坏死性淋巴结炎又叫kikuchi病,是一种良性自限性疾病,该病在1972年由日本学者kikuchi及Fujimoto分别提出,主要表现为发热、淋巴结肿大、白细胞减少。我们对32例组织细胞坏死性淋巴结炎患者的临床表现、淋巴结活检病理学特点及其诊治过程进行回顾性分析。     

非结核分枝杆菌性淋巴结炎病理学改变的初步研究

目的 探讨非结核分枝杆菌性淋巴结炎的特征性组织病理学改变.方法 建立非结核分枝杆菌性淋巴结炎的实验动物模型,光镜下观察组织病理学改变;对1例临床初步诊断为非结核分枝杆菌性淋巴结结核患者的病理组织标本经多重PCR方法检测筛选后,光镜下观察组织病理学改变.结果 非结核分枝杆菌感染所致的淋巴结炎的病理学改变与我们所熟知的淋巴结结核的病理学改变不完全相同.在动物模型中观察到的非结核分枝杆菌淋巴结炎的特征性病理学改变如下:(1)淋巴结内可见结节状肉芽肿形成,中央呈凝固性坏死,其中可见较多的中性粒细胞及其核碎屑.坏死区周围可见类上皮细胞、淋巴细胞、单核细胞,并可见纤维组织包裹.肉芽肿内外均可见朗汉斯巨细胞;(2)淋巴结内可见匐形性坏死,坏死旱长条状,中央部分为凝固性坏死,其中有大量中性粒细胞及其核碎屑,周围可见类上皮细胞、淋巴细胞及单核细胞,并可见纤维组织包绕;(3)淋巴结内可见星状和星芒状坏死.对初步诊断为非结核分枝杆菌性淋巴结炎的1例石蜡包埋组织标本,光镜下观察淋巴结内可见上皮样肉芽肿,匐行性坏死和星状坏死,坏死中可见大量中性粒细胞及其核碎屑,周围可见类上皮细胞、淋巴细胞、单核细胞、朗汉斯巨细胞;类上皮细胞的细胞核旱极性排列,周围并可见纤维组织或胶原组织包绕.结论 匐形性坏死、星状和星芒状坏夕匕、中央十酪样坏死中可见大量的中性粒细胞和粒细胞细胞核的碎屑、在中央坏死区的周围可见类上皮细胞胞核的极性排列,是非结核分枝杆菌性淋巴结炎的部分特征性组织病理学改变.     

组织细胞性坏死性淋巴结炎误诊17例分析

组织细胞性坏死性淋巴结炎(HNL)是一种独立的淋巴结非肿瘤性疾病，常因发热、淋巴结肿大而就诊。其临床及病理改变与恶性淋巴瘤、结核病等类似，很容易误诊。本文就我院1998年6月至2002年5月收治的17例HNL误诊原因分析如下。     

组织细胞坏死性淋巴结炎72例临床分析

目的探讨组织细胞坏死性淋巴结炎的临床特点、病因病理及诊疗方法。方法回顾性分析72例组织细胞坏死性淋巴结炎的临床资料。结果本病多发于学龄期儿童和青年女性,可能与病毒感染有关,主要表现为淋巴结肿大,长期发热,白细胞下降,血沉增快,乳酸脱氢酶升高,淋巴结活检具有典型的组织病理学特点,抗生素治疗无效,消炎痛部分有效,激素有显效,本病具有自限性和复发性。结论病理及免疫组化检查是确诊组织细胞坏死性淋巴结炎的主要依据,此病预后良好,但部分具有复发性,应注意随访。     

组织细胞坏死性淋巴结炎1例

组织细胞坏死性淋巴结炎１例青岛市胶州中心医院（２６６３００）胡日光肖壮青组织细胞坏死性淋巴结炎，又称Ｋｉｋｕｃｈ淋巴结炎、坏死性淋巴结炎、亚急性坏死性淋巴结炎等。临床上比较少见，且容易发生误诊。现将我们通过病理检查证实的１例报告如下。患者男性，４０岁...     

组织细胞坏死性淋巴结炎

目的提高对少见病组织细胞坏死性淋巴结炎的认识。方法对我科诊治的患者进行分析，并结合文献复习。结果组织细胞坏死性淋巴结炎是一种具有特殊临床病理过程的自限性淋巴结疾病，病因及发病机制不明，以顽固性发热、区域性淋巴结肿大和一过性白细胞减少为特征。结论临床表现具有非特异性，组织学形态较复杂，容易误诊。抗生素治疗对本病无效，而糖皮质激素是最有效的治疗药物。     

组织细胞性坏死性淋巴结炎五例报告

组织细胞性坏死性淋巴结炎(HNL)是一种少见的病因不明的以发热、淋巴结肿大且呈特殊病理过程的非肿瘤性疾病.该病临床无特异性,极易造成误诊.现将本院从1999年～2005年收治的经病理检查确诊的5例患者报告如下.     

组织细胞性坏死性淋巴结炎7例临床分析

自1977年以来，组织细胞性坏死性淋巴结炎不断见有报道，但名称不一，有称坏死性淋巴结炎、亚急性坏死性淋巴结炎等。本文报告7例组织细胞性坏死性淋巴结炎，并结合文献讨论其临床病理特征。     

组织细胞坏死性淋巴结炎13例临床和病理分析

目的 通过对13例组织细胞坏死性淋巴结炎(HNL)患者的临床和病例资料进行总结分析,以探讨其临床和病理特点.方法 回顾性分析1997年6月～2006年12月住院治疗的13例HNL患者的临床及病理资料.结果 所有患者均有发热和颈部淋巴结大,大多数患者白细胞减少、淋巴细胞比率增高、血沉增快,9例EBV-DNA阳性.初诊时7例误诊为淋巴瘤,4例误诊为淋巴结核,1例误诊为败血症.淋巴结活检HE染色可见典型的病理学改变.12例患者应用疗程为2～6个月的肾上腺皮质激素治疗,疗效显著,未复发.1例应用肾上腺皮质激素2周治愈,但6年后复发.结论 该病临床表现缺乏特异性,易误诊,确诊需进行淋巴结活检,CD标志免疫组化为关键依据,可用于排除T、B淋巴瘤,其病因可能与EB病毒感染有关,早期长疗程的激素治疗可能有助于减少复发.     

HISTIOCYTIC NECROTIZING LYMPHADENITIS (KIKUCHI'S DISEASE)

Abstract We report a typical case of histiocic necrotizing lymphadenitis. To our knowledge, this is the first reported case in Australasia. Histiocytic necrotizing lymphadenitis (Kikuchi's disease) is a distinct disorder originally reported in Japan. It commonly affects young females and involves mainly cervical lymph nodes. The condition is benign. The etiology of histiocytic necrotizing lymphadenitis and its distinction from other causes of benign and malignant lymphadenopathies are discussed. The clinical importance of this disorder is that, histopatholoaicallv. it could be misdiagnosed as malignant lymphoma and therefore patients may receive irkorrect treatment. (Aust NZ J Med 1986; 16: 711–713.)     

Necrotizing non-granulomatous lymphadenitis: a clinicopathologic study of 40 Thai patients

The purpose of this study was to describe the clinicopathological features of 40 cases of necrotizing non-granulomatous lymphadenitis in Thai patients. The clinical features, histomorphology and special stains were evaluated in 40 Thai patients from the pathology records of King Chulalongkorn Memorial Hospital from January 2001 to December 2003 in those diagnosed as having necrotizing non-granulomatous lymphadenitis. Of the 40 patients, 17 cases (42.5%) had Kikuchi-Fujimoto disease (KFD), 8 cases (20%) had tuberculosis (TB) lymphadenitis and 1 case (2.5%) had systemic lupus erythematosus (SLE) with associated lymphadenitis. Fourteen cases (35%) did not have a specific diagnosis due to a lack of follow-up data. KFD most commonly occurs in young women, and is characterized by the presence of coagulative necrosis and karyorrhexis often centered in the paracortex, an absence of neutrophils and plasma cells, proliferation of various cells composed of lymphocytes, histiocytes, immunoblasts and plasmacytoid monocytes and the absence of a granuloma. Tuberculous lymphadenitis usually occurs in women with a mean age of 34.25 years. The lymph nodes reveal extensive coagulative necrosis involving the cortex, paracortex and medulla, proliferation of mixed inflammatory cells, including neutrophils, lymphocytes and plasma cells in the necrotic area and the presence of proliferating histiocytes at the periphery of the necrotic area. The lymph nodes of SLE-associated lymphadenitis reveal large numbers of plasma cells and hematoxylin bodies. We suggest that necrotizing non-granulomatous lymphadenitis is not specific for any disease, but rather a common histologic change found in diseases, such as TB, SLE, and KFD. Further investigation to obtain a definite diagnosis should be done for appropriate treatment.     

Three clinical reports of Kikuchi's lymphadenitis combined with systemic lupus erythematosus

Summary The authors describe three cases of systemic lupus erythematosus (SLE) associated with Kikuchi's histiocitic necrotizing lymphadenitis (HNL). Two patients presented a cytomegalovirus infection concomitantly with Kikuchi's lymphadenitis; in one of them the onsets of SLE and HNL were simultaneous. In the third case an inguinal HNL was concomitant with vaginitis of unknown aetiology.     

组织细胞坏死性淋巴结炎

组织细胞坏死性淋巴结炎是一种具有特殊临床病理过程的自限性淋巴结疾病,以顽固性发热、区域性淋巴结肿大和一过性白细胞减少为特征。病因及发病机制不明,临床表现具有非特异性,组织学形态较复杂,容易误诊。抗生素治疗对本病无效,而糖皮质激素是最有效的治疗药物,大多预后良好。     

Kikuchi's disease and systemic lupus erythematosus: case report and review

The case of a 50-year-old male with a clinical syndrome consistent with systemic lupus erythematosus (SLE), generalized lymphadenopathy, and renal involvement is presented. The pathologic examination of an excised supraclavicular lymph node showed necrotizing lymphadenitis. Although necrotizing lymphadenitis is a well-known characteristic of SLE lymphadenitis, the main histologic and immunophenotypic findings of our case showed the presence of distinctive Kikuchi's lymphadenitis.     

Repeated Necrotizing Lymphadenitis with MEFV Gene Mutations

We herein report a 36-year-old man with repeated necrotizing lymphadenitis due to MEFV gene mutations. The patient''s chief complaints were a fever and painful cervical lymphadenopathy. We diagnosed him with necrotizing lymphadenitis based on the pathological findings of the lymph nodes and the exclusion of other differential diseases. The same episode recurred four times. We speculated the involvement of autoinflammatory backgrounds and detected MEFV gene mutations of E148Q (homo), P369S, and R408Q. Considering the elevation of interleukin-18, these mutations probably played roles in the repeated necrotizing lymphadenitis.     

An unusual cause of cervical lymphadenitis: Kikuchi-Fujimoto disease

Cervical lymphadenitis may be the result of diverse conditions in a patient. Clinical and epidemiologic information about cervical lymphadenitis can often lead to a presumptive diagnosis and, thus, limit the number of studies required as well as direct the type of initial therapy administered. We report a case of cervical lymphadenitis in a Vietnamese woman for whom a presumptive diagnosis of tuberculosis was made and antituberculous therapy was started. Pathologic examination of an excised lymph node revealed the correct diagnosis--histiocytic necrotizing lymphadenitis, or Kikuchi-Fujimoto disease. We review the clinical, epidemiologic, and pathologic features of this recently recognized disease. Careful examination of excised material from the lymph nodes should prevent patients who have Kikuchi-Fujimoto disease from receiving unnecessary treatment.