组织细胞坏死性淋巴结炎11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。方法：回顾性分析11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：所有患者均有颈部淋巴结肿大和持续性发热,大多数患者白细胞减少、血沉增快。11例患者均由颈部淋巴结活检确诊。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。应用疗程为2～4个月的肾上腺皮质激素治疗,疗效显著,未复发。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,确诊主要依靠淋巴结活检。     

组织细胞坏死性淋巴结炎2例

组织细胞坏死性淋巴结炎（histocyticBecrotizing]ymphadenitis,HNL）是一种少见的良性自限性疾病。1972年首先由日本学者Kikuehi和Fujimoto等报道,又称菊池病（Kikuchidisease）或Kikuehi—Fujimoto病（KFD）。该病以发热、颈部淋巴结肿大为主要临床表现,可累及多系统多器官,缺乏特异性,临床上容易误诊为淋巴瘤或淋巴结结核等,确诊主要依据淋巴结病理学检查。现将我院2007年收治的2例HNL的临床资料进行分析,现报道如下。     

Kikuchi-Fujimoto病的临床及病理学研究

Kikuchi-Fujimoto病(Kikuchi-Fujimoto disease,KFD)是一种较少见的良性自限性疾病,以原因不明的淋巴结尤其是颈部淋巴结肿大为特征.病理表现为含细胞核碎裂产物的淋巴结灶性坏死,坏死区周围有组织细胞、浆细胞样单核细胞、免疫母细胞等多种细胞成分聚集,但无粒细胞浸润.KFD可能与自身免疫因素相关,确诊主要依赖病理检查.     

颈部亚急性坏死性淋巴结炎所占表浅淋巴结的比率及临床表现

亚急性坏死性淋巴结炎 ,是主诉全身各部表浅淋巴结肿胀 ,伴有高热和疼痛 ,经过 2～ 3个月自然治愈 ,预后良好的疾患。文章重点对颈部亚急性坏死性淋巴结炎临床表现及治疗进行了统计观察。1987年 4月～ 1997年 3月 10年内 ,全身各处表浅淋巴结活检 6 2 9例 ,其中颈部淋巴结活检 4 2 1例(72 % ) ,经病理确诊亚急性坏死性淋巴结炎 54例 ,占全组的 9% ,占颈部淋巴结 13%。男 18例 ,女 36例 ,10～ 30多岁青年好发 ,占全组的 87% ,年龄最小 6岁 ,最大 4 5岁 ,平均年龄男 19岁 ,女 2 5岁 ,每年 10月～ 3月多发。记录临床症状和经过 4 0例 ,发热 34…     

颈部组织细胞坏死性淋巴结炎的诊断治疗分析

组织细胞坏死性淋巴结炎(histiocytic necrotizing lymphadenitis,HNL)又称为Kikuchi-Fujimoto病(KikuchiFujimoto disease,KFD),或Kikuchi病,是多见于年轻女性的一种良性自限性疾病.首诊的临床表现多为颈部淋巴结的肿大,半数以上的患者同时伴有发热和外周血淋巴细胞的减少[1].病程在数周至6个月不等,超过6个月的患者很少.该病在世界各地均有零散病例报道,以东亚人群为主.本文报道13例HNL患者诊断治疗资料.     

Kikuchi—Fujimoto病的临床及病理学研究

Kikuchi—Fujimoto病(Kikuchi—Fujimoto disease，KFD)是一种较少见的良性自限性疾病，以原因不明的淋巴结尤其是颈部淋巴结肿大为特征。病理表现为含细胞核碎裂产物的淋巴结灶性坏死，坏死区周围有组织细胞、浆细胞样单核细胞、免疫母细胞等多种细胞成分聚集，但无粒细胞浸润。KFD可能与自身免疫因素相关，确诊主要依赖病理检查。     

29例颈部坏死性筋膜炎临床分析

目的：探讨颈部坏死性筋膜炎的临床特点及治疗经验。方法：29例颈部坏死性筋膜炎患者均经CT检查确诊,其中12例行气管切开并行颈侧切开排脓探查术,另17例仅行颈侧切开排脓探查术,术中颈部脓肿切开引流,术后冲洗换药并进行抗感染治疗。结果：28例患者治愈出院,1例死亡。其中有2例并发颈内静脉血栓,4例并发纵隔感染,后经治疗后痊愈。随访半年无复发病例。结论：颈部坏死性筋膜炎患者确诊后应尽早采取手术探查,行颈部脓肿切开引流治疗,可获得满意疗效,并有助于预防严重并发症。     

颈部巨淋巴结增生临床分析

目的 提高对颈部巨淋巴结增生(Castleman病)的诊断水平.方法 回顾性分析曾经误诊的10例巨淋巴结增生的临床资料,分析临床诊断和鉴别诊断的经验和教训.结果 10例颈部巨淋巴结增生患者,男3例,女7例;按Frizzera分类标准分为局灶性8例(其中透明血管型6例,混合型2例),多中心性2例(其中浆细胞型1例,混合型1例).临床以无痛性颈淋巴结肿大为特征,多中心性2例伴有全身症状和(或)多脏器受累等特征.10例患者均为误诊后接受淋巴结切除术后病理检查确诊.随访4～17年10例患者均健康生存,其中1例多中心性浆细胞型患者术后2年复发,再次接受淋巴结手术切除术和化疗后4年未再复发.结论 颈部巨淋巴结增生临床少见,易于误诊,应采用淋巴结切除活检术病理检查确定诊断,注意与颈淋巴结结核、颈淋巴结炎、结节病、肉芽肿等鉴别.如无系统功能严重受累,首选手术切除.     

彩超在诊断分化型甲状腺癌颈淋巴结转移中的应用

目的评价彩超在诊断甲状腺癌患者颈淋巴结转移中的作用.方法回顾性分析1998年2月～2002年2月收治51例颈淋巴转移的甲状腺癌患者的临床资料：30例（34侧）颈部可触及有肿大淋巴结并经彩超检查诊断有颈淋巴结转移;21例（24侧）颈部未触及有肿大淋巴结但彩超检查诊断有颈淋巴结转移.对上述58侧颈部实行改良性颈清扫,将术前彩超检查结果与术后病理结果进行比较.结果彩超诊断有颈淋巴结转移的58侧行改良性颈清扫术后53侧病理报告有转移淋巴结,彩超检查的灵敏度为91.4%（53/58）.4例患者在随访过程中发现颈侧区淋巴结转移,复发率为7.5%.彩超可以发现39.6%有临床漏诊颈淋巴结转移的患者.术前彩超检查：中颈淋巴转移率最高71.7%（38/53）;术后病理检查：Ⅲ区淋巴转移率最高67.9%（36/53）,其结果基本相同.结论彩超在术前可以判断是否发生颈淋巴结转移并能够准确定位,在甲状腺癌的术前颈淋巴结的评价中十分重要,甲状腺癌患者应常规进行术前彩超检查.     

颈部组织细胞坏死性淋巴结炎1例及文献综述

患者女,23岁,广东人。因“右颈部包块1周”以“右颈淋巴结肿大性质待查”收入院。患者述1周前无明显诱因发现右侧颈部略有隆起,无任何不适感。在当地医院按照“淋巴结炎”给予消炎治疗5天,右侧颈部隆起处无明显缓解,遂来我院就诊。查体：右侧颈部Ⅱ区可触及2～3枚肿大淋巴结,1．0～2．5cm大小,质中,无明显压痛,与周围无明显粘连。入院诊断：右颈淋巴结肿大性质待查：①鼻咽癌伴右颈淋巴结转移;②淋巴结结核;③淋巴瘤。入院后行鼻咽部活检,鼻咽部cT,EB病毒二项检查,结核菌素试验,胸部拍片,结果均为阴性。     

Kikuchi-Fujimoto's syndrome masquerading as tuberculosis.

We report a case of a 27-year-old Asian man presenting with the typical features of tuberculous cervical lymphadenitis who was commenced on anti-tuberculous therapy on the strength of the clinical presentation. Histological examination of an excised cervical lymph node however, revealed the diagnosis of Kikuchi's syndrome; a histiocytic necrotizing lymphadenitis which is usually self-limiting.     

Kikuchi — Fujimoto disease

Kikuchi — fujimoto disease also known as histiocytic necrotizing lymphadenitis is an idiopathic benign self limiting condition with a favourable outcome, usually affecting young women. The following cases have burn reported for clinical interest and for the rarity of the reports about this condition in ENT literature. In our series, we had 2 female patients aged 18 years and 25 years respectively and a male patient aged 45 years, presenting with fever, bilateral tender multiple cervical adenopathy including posterior triangle nodes not responding to routine antibiotics and anti-inflammatory drug treatment. ENT findings were within normal limits. Routine clinical investigations were within normal limits except for the raised ESR. Biopsy from one of the enlarged glands revealed necrotizing lymphadenitis. All the patients subsequently showed significant improvement locally in the neck and systemically without any further active treatment.     

颈淋巴结结核临床分析

目的探讨颈淋巴结结核的临床特点、诊断及治疗方法。方法回顾性分析2004年10月～2011年5月我院收治的83例颈淋巴结结核患者的临床资料。结果 83例颈淋巴结结核患者,女性多见;肿块位于颈侧中上部30例(36.1%),锁骨上窝32例(38.6%);合并肺结核的12例(14.5%);31例行颈部CT扫描,21例增强扫描表现为肿物环形强化;11例行淋巴结针吸活检,8例确诊,其余3例经淋巴结活检确诊;3例抗结核治疗无效。结论颈淋巴结结核以颈侧部和锁骨上窝肿块为主要表现,部分合并肺结核;颈部增强CT扫描有重要的诊断价值;针吸活检不能确诊的应尽早手术活检;多数患者只需行抗结核治疗,无效者需行手术治疗。     

Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease) diagnosed by fine needle aspiration biopsy.

A case of histiocytic necrotizing lymphadenitis involving a right submandibular lymph node is described in a 14-year-old Caucasian boy. The diagnosis was established on initial assessment by fine needle aspiration biopsy. Excisional biopsy, performed because the lymph node enlargement failed to regress, confirmed the cytological findings.     

Kikuchi's disease as the etiology of chronic neck adenopathy

Kikuchi's disease, a rare cause of chronic cervical adenopathy, does not have specific clinical signs. There is a general deterioration in the condition of the patient accompanied by cervical adenopathy. The diagnosis is made histologically by the recognition of histiocytic necrotizing lymphadenitis. The prognosis is usually favorable with spontaneous resolution within a few weeks to a few months.     

Kikuchi's Disease: Report of Three Cases and an Overview

We describe, to our knowledge, the first native Finnish patients with Kikuchi's histiocytic necrotizing lymphadenitis. The diagnosis was based in all cases on histopathological findings in openbiopsy. The disease was first detected in Japan in 1972, but in Scandinavia, until this decade, there had been no cases reported. Our patients were young, otherwise healthy women who had cervical lymphadenopathy, fever, and fatigue as their main symptoms. In two of them, the disease was mild and subsided spontaneously within 2-6 months. One patient with more fulminant lymphadenopathy was treated with antimicrobial and antiinflammatory drugs. She became symptomless in 3 months. The cause of Kikuchi's disease is unknown. A viral or postviral hyperimmune reaction has been proposed as its etiology. Malignant lymphoma and systemic lupus erythematosus are differential diagnoses. Histopathological findings are pathognomonic and pathologists must be aware of its typical characteristics.     

Pediatric Kikuchi-Fujimoto disease masquerading as a submandibular gland tumor

Kikuchi-Fujimoto disease, also known as histiocytic necrotizing lymphadenitis, is a rare disorder that typically affects the cervical lymph nodes. The disease usually occurs in women in their late 20s or early 30s. Reports in the pediatric literature are sparse. Most authors consider Kikuchi-Fujimoto disease as a self-limiting disorder that requires no specific management but long-term follow-up. The clinical features of Kikuchi-Fujimoto disease are easily confused with other less-benign conditions. Thus, an early biopsy is instrumental in making definite diagnosis and preventing unnecessary investigations. We describe a case of Kikuchi-Fujimoto disease in an 8-year-old boy which presenting as a submandibular gland tumor. The case illustrates the clinical features of this unusual condition and emphasizes the potential confusion with other diagnoses.     

Kikuchi-Fujimoto disease: a report of 3 cases

Cervical lymphadenopathy has many underlying etiologies. One of its rare causes is Kikuchi-Fujimoto disease (Kikuchi's disease, histiocytic necrotizing lymphadenitis). We discovered such a cause in a 37-year-old woman who had presented with malaise, night sweats, and weight loss in addition to cervical lymphadenopathy. We based our diagnosis on excisional lymph node biopsy. We also review 2 other cases of Kikuchi's disease that were diagnosed by others at our institution. Clinically and histologically, Kikuchi's disease is very similar to lymphoma, and distinguishing the two is difficult. However, despite the fact that Kikuchi's disease is benign, an accurate diagnosis is important because misdiagnosis might lead to unnecessary surgery and/or chemotherapy.     

原发性颈淋巴结结核的临床特征与治疗

目的：探讨原发性颈部淋巴结结核的临床特征和治疗方法。方法：回顾性分析32例原发性颈部淋巴结结核患者的临床资料。32例患者中29例活检前行CT检查,4例行细针穿刺针吸活检确诊,28例行手术病理检查确诊。27例行肿块全部切除或区域性颈部淋巴结清扫术,术后全身抗结核治疗6个月;5例确诊后行常规抗结核治疗1年。结果：CT显示肿块呈均匀或不均匀强化,部分肿块呈融合现象。全部病例治疗后均行随访,手术患者术后切口均Ⅰ期愈合,1例术后抗结核治疗3个月肿块增大,再次手术确诊为颈部淋巴结结核并发鼻咽癌颈部淋巴结转移,转肿瘤科治疗,其余31例患者均无颈部淋巴结结核复发和其他结核病表现。结论：原发性颈部淋巴结结核临床特征发生改变,颈部肿块为首发症状,多数位于颈后三角区。CT检查有助于本病的诊断和鉴别诊断。全身抗结核药物和手术切除淋巴结的联合应用能有效地治疗原发性颈部淋巴结结核。原发性颈部淋巴结结核的治疗应以手术为主,手术治疗能缩短治疗时间、减少药物用量及不良反应,防止冷脓肿及窦道形成。