四川医学2017，Vol.38Issue(5)：510-513,4.DOI:10.16252/j.cnki.issn1004-0501-2017.05.007
组织细胞坏死性淋巴结炎42例临床分析
Clinical Analysis of 42 Cases of Histiocytic Necrotizing Lymphadenitis
吴岑 1栾九松 1周晓明 1谷秀1
作者信息
- 1. 中国医科大学附属盛京医院呼吸科,辽宁 沈阳 110004
- 折叠
摘要
Abstract
Objective To study the clinical characteristics of histiocytic necrotizing lymphadenitis(HNL).Methods The pathological diagnosis of histiocytic necrotizing lymphadenitis was taken as diagnostic criteria.The clinical data of 42 cases of HNL patients received in our hospital from 2007 to 2015 were analyzed retrospectively.Results 42 cases of pathologically diagnosed cases were included,which consisted of 12 males and 30 females with a mean age of(27.4±12.0).The main clinical manifestations included fever(97.6%),lymphadenectasis(100%),lymph node tenderness(69.0%),rash(40.5%)and precursory symptoms of upper respiratory infection(40.5%).The laboratory examination results showed that 85.7% patients were accompanied by leukopenia and 42.9% patients had positive or weakly positive antinuclear antibody.Patients were all received antibiotic therapy at early stage.After the ineffective treatment of antibiotics,27 cases(66.7%)were changed to 0.5~1.0 mg/kg Prednisone every day and their body temperature dropped to normal after 2~5 days,14 cases(33.3%)remitted after symptomatic treatment and 1case(2.4%)got spontaneous remission,but 3 cases(7.1%)relapsed.Conclusion HNL is characterized by persistent fever,painful superficial lymphadenectasis and leukopenia.Its pathological characteristics includes emergence of histocytes with karyorrhexis and proliferating mononuclear cells.Anti-infective therapy is ineffective,but some patients can get spontaneous remission and glucocorticoid is efficacious.Some patients can combine with or progress to rheumaimmune systemic diseases,so patients need to be followed up for 1-2 years.In especial,patients with pathological results of proliferative or necrotic type have higher possibility of relapse than patients with pathological results of xanthoma type,who need more attention.关键词
组织细胞坏死性淋巴结炎/诊断/治疗Key words
histiocytic necrotizing lymphadenitis/diagnosis/reatment分类
医药卫生引用本文复制引用
吴岑,栾九松,周晓明,谷秀..组织细胞坏死性淋巴结炎42例临床分析[J].四川医学,2017,38(5):510-513,4.
