组织细胞坏死性淋巴结炎53例临床病理分析

目的：研究组织细胞坏死性淋巴结炎病理特点及其与淋巴瘤的鉴别。方法：对53例组织细胞坏死性淋巴结炎的临床表现，病理形态及免疫组化特点进行分析。结果：病变淋巴结多位于头颈部，呈轻－中度肿大，男女之比为1：1．7活检标本多破碎（37／53），形态特征为细胞碎片，增生的淋巴及组织细胞构成大小不一凝固性坏死灶。新月形、肾形、扭曲核的组织细胞及浆样T细胞最常见到，无中性粒细胞，免疫化坏死灶及边缘CD68及T细胞呈斑块状（＋），而B细胞少数散在（＋）。结论：根据组形态，细胞成分及免疫组织化学表型，组织细胞坏死性淋巴结炎可以明确诊断。

Histiocytic necrotizing lymphadenitis: a clinicopathological study of 53 cases

Objective To study the clinicopathological features of histicytic necrotizing lymphadenitis, and the differences from lymphoma. Methods Clinicopathological characteristics, morphological appearance and immunohistochemical features were analysed in 53 cases of Kikuchi lymphadenitis. Results The most common symptoms were cervical lymphadenopathy All the lymph nodes were mild to median size (<3cm) The female to m ale ratio was 1.8 to 1.0. Fragmentation of the biopsy was a frequent features (37/ 53) Morphologically, it was characterized by variable sized necrosis that composed of eosinophilic granular debris and basophilic karyorrhectic debris admixed with proliferated lymphoid and histiocytic cells The crescentic, reniform irregularly groved, twisted or contorted nuclei of the histiocytes and plasmacytoid T cells were often found, and neutrophils were absent Immunohistochemically, CD68 and T cell antibody (DFT1 and UCHL1)were strongly positive in necrosis and the fringer, and the B cell antibody (L26 and 4KB5) were scarcely positive Conclusions Kikuchi's lymphadenitis can be diagnosed with con fidence with the architectural features, characteristic cytologic composition and immunohischemical staining.