儿童亚急性坏死性淋巴结炎临床病理分析

目的:探讨儿童亚急性坏死性淋巴结炎(subacute necrotizing iymphadenitis)的临床病理特点。方法:回顾性分析19例儿童亚急性坏死性淋巴结炎病例的临床资料,全部病例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:19例中男性14例,女性5例,平均年龄7.3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,坏死灶边缘可见浆样单核细胞、多形核细胞及免疫母细胞,无或很少有中性粒细胞浸润。随访5月~3年,全部存活。结论:儿童亚急性坏死性淋巴结炎是一种良性自限性疾病,具有特殊的临床表现和独特病理特点;掌握其临床和病理形态学特点,有助于与其他病变相鉴别。

Analysis of clinical and pathological features of children's subacute necrotizing lymphadenitis

Objective:To study the clinical and pathological features of children's subacute necrotizing lymphadenitis.Methods:Ninteen cases of children's subacute necrotizing lymphadenitis were collected to analyze histopathological changes and clinical data,and immunohistochemical stainings.All the cases were followed-up.Results:The nineteen cases consisted of five females and fourteen males,with mean 7.3 years old.Main clinical features were fever,lymphadenopathy and neutropenia.Histopathologiacally,lymph node showed distinctive necrosis,loss of lymth node structure with many histiocytes and absence of neutrophils reaction,many plasmacytoid monocytes and immunoblasts existed.Ninteen patients survived during follow-up.Conclusion:Children's subacute necrotizing lymphadenitis is a morphologically distinctive disease with a comparatively favorable prognosis.Recognition of its clinicopathology feature is crucial to differential diagnosis of children's subacute necrotizing lymphadenitis.