郎格罕细胞组织细胞增生症的病理诊断

探讨病理检查在郎格罕细胞组织细胞增生症的诊断中的作用。收集我院 1991～ 2 0 0 1年间收治的诊断为小儿郎格罕细胞组织细胞增生症共 76例住院病人的资料总结分析。结果 ,76例病人 67例依据皮疹印片或病理活检诊断 ( 88 2 % ) ,1例依据骨髓检查诊断 ,其余依据临床和依据临床和影像学检查诊断。皮疹印片 18例 ,12例阳性 ;5 5例行病理检查 ,取材自皮肤、淋巴结、肿物 (包括腹腔、头部、纵隔肿物 )及骨损处穿刺或刮除物检查 ,找到郎格罕组织细胞 ;2 5例行S 10 0检查 ,2 4例阳性 ( 96% )。 3 9例行骨髓检查仅 1例示组织细胞明显增加 ,其余示增生骨髓象或增生减低。结果表明 :病理检查是郎格罕细胞组织细胞增生症的确诊的唯一手段。皮疹印片对LS病的诊断有特殊意义 ,骨髓检查诊断价值有限。HSC及EGB的病人诊断有赖于病灶局部肿物、淋巴结活检或病损骨组织的病理检查 ,S 10 0阳性有助于对不确定病例的诊断及提高诊断的可信度。

The pathologic diagnoses of Langerhans cell histocytosis

Objective: To investigate the importance of pathologic examination i n the diagnosis of Langerhans cell histocytosis(LCH). Method: The data of 76 child ren diagnosed as LCH hospitalized from 1991 to 2001 in our hospital were analyze d. Result: 67 cases were diagnosed by skin eruption imprint cytologic examinatio n or pathologic biopsy(88 2%). 1 case diagnosed by bone marrow examination. Oth ers were diagnosed by clinical and image examination. 18 cases had skin eruption imprint, 12 cases were positive. 55 cases had pathologic examination from skin, lymph node, tumor tissues (from abdominal cavity, head and mediastinum) and pun ctured tissue from bone lesion, all found Langerhans cell. 25 cases detected S 100, 24 were positive (96%). 39 cases had bone marrow examination, while only 1 case showed histocytosis, others showed bone marrow hyperplasia or aplasia. Conc lusion: Pathologic examination were the only way to final diagnosis of LCH. Skin eruption imprint cytologic examination had special significance to the diagnosi s of LS, while the use of bone marrow examination was limited to the diagnosis. The diagnosis of HSC and EGB were depended on the pathologic examination of loca l lesion tumor, lymph node or bone lesion. The positive of S 100 is not only us eful to the diagnosis of uncertain cases but also higher the confidence level of diagnosis.