中国感染控制杂志2016，Vol.15Issue(10)：735-738,4.DOI:10.3969/j.issn.1671-9638.2016.10.004
以发热伴关节肿痛为特征的组织细胞坏死性淋巴结炎1例报道
Histiocytic necrotizing lymphadenitis characterized by fever and joint pain:a case report
摘要
Abstract
A 27-year-old woman was admitted to a hospital due to intermittent fever for 20+ days and swelling pain in knee joint for 7 days.Patients was with persistent fever,the highest temperature to 40.1°C,the double knee joint swelling pain,a large number of scattered red needle-like rash were visible on bilateral hands and legs,lymph-adenectasis,splenectasis,bilateral hands interphalangeal joint and knee joint swelling pain,lymph nodes were con-fined to the bilateral axillary with soft texture,local tenderness,and good activity.Pathological results of left axil-lary lymph node showed the following finding:fragmental lymph node tissue with incomplete structure,lymphoid follicles existed,there were diffuse histocytes,immunoblasts,and a few small lymphocytes proliferation in the re-duced or disappeared area of follicular,caryokinesis could be easily seen,there were patches of necrosis foci with varied size,nucleus disintegrated,fibrinoid necrosis blood vessel with bleeding could be seen.Immunohistochemical detection showed the following results:CD3 (diffuse +);CD20 (follicular +);CD79α(follicular +);CD68 (+);EMA (-);ALK (-);CD15 (a small amount of cells +);CD30 (+),CD4 (-),CD5 (+);CD10 (-);bcl-2 (+);CD21 (+);telomerase B (-);TIA-1 (-);EBV(-)Ki-67 (+).Through a combination of clinical and immunohistochemical detection results,the diagnosis of histiocytic necrotizing lymphadenitis was made.Patient discontinued antimicrobial drugs,after she was treated with 5% glucose 100 mL + hydrocortisone sodium succinate 200 mg intravenous drip for 3 days,patients had no fever,axillary lymph node gradually dwindled.Then patients was treated with methylprednisolone 8 mg/d,twice a day,reduced 1 tablet every two weeks,and stopped eventual-ly.Patients was followed up for two years,repeated examination of blood routine,liver and kidney function were in the normal range,bilateral knee didn’t swell,could walk freely,there appeared no enlargement of lymph node.关键词
发热/关节肿痛/组织细胞坏死性淋巴结炎Key words
fever/joint swelling pain/histiocyte necrotizing lymphadenitis分类
医药卫生引用本文复制引用
汪四海,韩宁林,李雪苓,窦红曼,吴倩,邢学伟..以发热伴关节肿痛为特征的组织细胞坏死性淋巴结炎1例报道[J].中国感染控制杂志,2016,15(10):735-738,4.基金项目
国家自然科学基金（NO．81173211）；安徽现代中医内科应用基础与开发研究省级重点实验室建设项目（科基［2014］62号）；安徽省卫生厅中医药科研基金项目（2012ZY05）；安徽省高校自然科学研究项目（KJ2011Z226）；安徽中医药大学青年科研基金项目 （）
