组织细胞坏死性淋巴结炎临床分析

目的分析组织细胞坏死性淋巴结炎的临床资料。方法回顾性分析经病理证实的43例组织细胞坏死性淋巴结炎患者的临床特点和治疗过程、预后。结果 43例患者的男女发病率为1：1.15,所有患者均有颈部淋巴结肿大,77%患者伴有发热。20例行糖皮质激素治疗,13例未予药物干预,8例予消炎、止痛等对症治疗,2例手术清扫颈部肿大淋巴结。5例并发感染或自身免疫性疾病,其中2例死亡。随访22例中有5例复发,再次激素治疗有效。结论组织细胞坏死性淋巴结炎的临床表现、实验室和影像检查缺乏特异性,淋巴结活检病理检查可明确诊断。可并发自身免疫性疾病,有必要定期监测免疫功能和随访。

Clinical investigation of patients with histiocytic necrotizing lymphadenitis

OBJECTIVE To evaluatet he clinicopathologic characteristics of histiocytic necrotizing lymphadenitis. METHODS The clinical data of 43 patients with histiocytic necrotizing lymphadenitis proved by pathology were reviewed retrospectively. RESULTSThe male-female ratio was 1：1.15. All patients had cervical lymphadenopathy,and 58% of them had bilateral lymphnode involvement, 77% of them had prolonged fever,while sore throat, fatigue, erythematous rashes, elevated ESR（82%） and CRP（61%）, leucopenia（44%） were the most common findings. CT scans demonstrated multiple and string-of-beads lymph notes. Twenty patients were treated with glucocorticoids, while 13 patients achieved remission of symptoms spontaneously and 8 received symptomatic treatment. Five of 22 telephone followed-up patients had a recurrence and glucocorticoids still had efficacy. Another 5 patients had intercurrent diseases, and 2 of them died. CONCLUSION The histiocytic necrotizing lymphadenitis has no specific imaging, laboratory and clinical findings. Biopsy of the cervical lymph nodes is the only way to make a definite diagnosis. It could be companied with autoimmune disease, so long-term follow-up is needed.