猫抓病性淋巴结炎的临床病理分析

目的：探讨猫抓病性淋巴结炎的诊断和鉴别诊断要点，方法：应用免疫组化S－P法对26例猫抓病性淋巴结炎分别标记CD20、CD3、CD68；15例进行Warthin-Starry银染色，结果：早期微脓生肉芽肿21例，其病变特征是微脓肿和肉芽肿形成。淋巴结早期微脓肿周围为CD20＋的B淋巴细胞和CD68＋组织细胞，当典型微脓肿性肉芽肿形成时，CD68＋的类皮细胞呈放射状排列，其间夹有CD3＋T淋巴细胞；15例中12例Warthin-Starry染色（＋）。结论：猫抓病灶性淋巴结炎的主要特征是微脓肿性肉芽肿形成，免疫组化标记有助于识别病变中反应增生的细胞成分，本病可能与细菌感染所诱导的细胞免疫反应有关。

Lymphadenitis in cat scratch disease(CSD):A clinicopathological study

Purpose To study the main points of the diagnosis and differential diagnosis of the lymphadenitis in CSD. Methods Expression of CD45, CD3 and CD68 were evaluated immunohistochemically (S P method). Results Five cases of microabscess in early stage and 21 cases of microabscess granuloma were found. The histologic features were the formation of microabscess and granuloma. The early microabscess in the lymphnodes were surounded by B lymphocytes (CD20+) and macrophages (CD68+). The typial microabscess granuloma were surrounded by epitheloid cells (CD68+) and CD3 positive T lymphocytes. Conclusion The main characteristic of the lymphadenitis of cat scratch disease is the formation of granuloma with microabscess. The immumohistochemical markers are useful to distinguish the proliferative cell types. This lesion may result from bacterial infection which induces the cell immune reaction.