透明血管型Castleman病旁淋巴结临床病理分析  

Clinicopathologic changes of lymph nodes adjacent to hyaline-vascular Castleman disease

作　　者：吴丽莉[1] 

机构地区：[1]第二军医大学长海医院病理科,上海200433

出　　处：《诊断病理学杂志》2007年第3期186-189,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的了解透明血管型Castleman病(HVCD)旁淋巴结的病理改变。方法通过光镜观察及免疫组化检测,对7例HVCD旁淋巴结进行形态学观察和免疫表型定位。结果7例淋巴结内淋巴窦结构均存在;皮质层有较多滤泡,多数生发中心小甚至无;套区看似明显增厚,用IgD标记套区,发现其中3例确有套区增生,其余为边缘区细胞增生;5例偶见滤泡生发中心退变;2例出现呈洋葱皮样排列的套区;1例偶见透明血管滤泡;1例存在含多个生发中心的单个滤泡;滤泡间区高内皮静脉增生不明显。结论HVCD旁淋巴结可以局灶性呈现HVCD的部分病理特征,滤泡常有看似增厚的“套区”。因此,在先行较大肿块旁淋巴结活检时,如发现上述特征,应考虑周围有无HVCD原发灶的存在。Objective To describe the histologic features of lymph nodes adjacent to hyaline-vascular Castleman disease （HVCD） lesions. Methods Seven cases of HVCD in which adjacent lymph nodes were available were identified. H-E stained sections were examined and staining was performed. Results All the lymph nodes had preserved sinuses, and showed many follicles. Most follicles had small or no germinal centers, and presented apparently prominent mantle zones However, in immunostaining for mantle cells （IgD）, mantle zones were genuinely thickened in 3 cases; most follicles actually showed marginal zone rather than mantle zone hyperplasia. Occasional regression of germinal center （5 cases）, onion-skirting of mantle zone （2 cases）, hyaline vessels in germinal center （ 1 case） and follicles with multiple germinal centers （ 1 case） were identified in this group. In interfollicular zone, prominently hyperplasia of high endothelial venules were not observed. Conclusions Lymph nodes adjacent to HVCD lesions can show some incompletely developed features of HVCD and follicles with apparently thick mantle zone. The findings of these features in lymph nodes may prompt the possibility of nearby HVCD if a small lymph node adjacent to a large lesion is biopsied.

关 键 词：透明血管型Castlema病 套区 边缘区 透明血管滤泡 淋巴结 

分 类 号：R551.2[医药卫生—血液循环系统疾病]