组织细胞坏死性淋巴结炎合并嗜血细胞综合征一例报道并文献复习

发布时间：2018-02-12 10:02

本文关键词： 组织细胞坏死性淋巴结炎嗜血细胞综合征正电子发射断层显像术病理学鉴别诊断　出处：《中国全科医学》2017年35期 　论文类型：期刊论文

【摘要】：组织细胞坏死性淋巴结炎病因及发病机制未明,以顽固性发热、区域性淋巴结肿大伴或不伴压痛和一过性白细胞计数减少为特征。该病临床表现、实验室及影像学检查均无特异性,且相对少见,临床极易误诊为淋巴瘤、系统性红斑狼疮等疾病,确诊主要根据组织病理检查及免疫组织化学检查。本文报道1例患者表现为持续高热、颈部淋巴结肿大伴压痛、消瘦患者,抗生素治疗无效,~(18)F-FDG正电子发射断层显像/计算机断层成像(PET-CT)检查示全身多发淋巴结肿大,最大标准摄取值(SUV_(max))高达20.4,高度怀疑恶性淋巴瘤。该患者经颈部淋巴结活检证实为组织细胞坏死性淋巴结炎,且骨髓细胞学检查提示嗜血细胞增多骨髓象,最终诊断为组织细胞坏死性淋巴结炎合并嗜血细胞综合征。
[Abstract]:The etiology and pathogenesis of histiocytic necrotizing lymphadenitis are unknown, characterized by obstinate fever, regional lymphadenopathy with or without tenderness and transient leukopenia. Laboratory and imaging examinations are non-specific and relatively rare. They are easily misdiagnosed as lymphoma, systemic lupus erythematosus and other diseases. The diagnosis was mainly based on histopathological examination and immunohistochemical examination. This paper reports a patient with persistent high fever, cervical lymph node enlargement with tenderness, and wasting. Non-effective antibiotic therapy with 18 F-FDG positron emission tomography (PET) / computed tomography (CT) showed multiple lymphadenopathy throughout the body. The maximum standard uptake value was as high as 20.4 and highly suspected of malignant lymphoma. The patient was confirmed by cervical lymph node biopsy as histiocytic necrotizing lymphadenitis, and bone marrow cytology showed that hemophilic cells increased in bone marrow image. The final diagnosis was histiocytic necrotizing lymphadenitis with Haemophilus syndrome.
【作者单位】：第二军医大学附属长海医院全科规培基地;第二军医大学附属长海医院风湿免疫科;第二军医大学附属长海医院呼吸内科;
【分类号】：R551.2

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