浅表淋巴结肿大的151例艾滋病患者淋巴结病理学分析  

Analysis of the pathology of lymph nodes in 151 acquired immune deficiency syndrome patients with superficial lymphadenectasis

作　　者：卢祥婵[1] 邓建宁[1] 黄爱春[1] 李雪琴[1] 牟敏红[2] 欧汝志[1] 黄磊[3] 赵敏[3] 

机构地区：[1]南宁市第四人民医院感染科,530023 [2]南宁市第四人民医院病理科,530023 [3]解放军第三〇二医院感染性疾病诊疗与研究中心

出　　处：《中华传染病杂志》2011年第7期406-409,共4页Chinese Journal of Infectious Diseases

基　　金：国家自然科学基金资助项目（30771897）;首都医学发展科研基金项目（2007-3036）;2010年南宁市科学研究与技术开发计划、创新计划项目科研课题（201003047C-1）

摘　　要：目的 探讨浅表淋巴结肿大的HIV/AIDS患者的淋巴结病理类型及其特点.方法 取浅表淋巴结肿大的151例HIV/AIDS患者的淋巴结组织进行病理学检查,通过HE、抗酸、过碘酸雪夫和淀粉酶消化后过碘酸雪夫染色,光学显微镜下观察,描述和分析其病理结果及其与CD4＋T淋巴细胞计数的关系.数据行卡方检验.结果 在151例HIV/AIDS患者的淋巴结病理结果中,表现为良性病变的有145例,占96.0%,表现为恶性肿瘤的有6例,占4.0%,其中结核病72例,淋巴结反应性增生34例,淋巴真菌感染23例（其中青霉病19例）,AIDS相关淋巴结病14例,非霍奇金淋巴瘤5例,良性纤维组织细胞病1例,结核伴发真菌感染1例,间叶性恶性肿瘤1例.在所有患者中,CD4＋T淋巴细胞计数〈100×106/L的有83例,占55.0%.青霉病随着CD4＋T淋巴细胞计数的减少,发病率明显升高（x2=7.757,P=0.021）.结论 HIV/AIDS患者浅表淋巴结肿大的原因大多数为感染性疾病,主要为结核病及真菌感染,且多数发生在CD4＋T淋巴细胞计数低下的患者,最常见的恶性肿瘤为非霍奇金淋巴瘤.Objective To investigate the pathological types and features of lymph nodes in human immunodeficiency virus（HIV）/acquired immune deficiency syndrome（AIDS）patients with superficial lymphadenectasis.Methods The tissues of lymph nodes were obtained from 151 HIV/AIDS patients with superficial lymphadenectasis for pathological examination.The pathological results were observed by light microscope after Hematoxylin-Eosin（HE）,acid-fast,periodic acid-Schiff （PAS）,and digested-PAS（D-PAS）staining.The pathological results of lymph nodes were described and the correlation between pathological changes and CD4＋T lymphocyte count was analyzed.Chisquare test was used for the statistic analysis.Results The benign lesions were found in 145 patients （96.0%）,while the malignant tumors were found in 6 patients（4.0%）.The pathological findings in the 151 HIV/AIDS patients included tuberculosis（72 patients）,lymph node reactive hyperplasia（34patients）,lymphatic fungal infections（23 patients,including penicillium diseases in 19 cases）,AIDSrelated lymphadenectasis（14 cases）,non-Hodgkin lymphoma（5 cases）,benign fibrous histiocytoma （1 case）.In addition,there were 83 patients（55.0%）with CD4＋T lymphocyte count lower than 100×106/L.The frequency of penicillium diseases was higher in patients with lower CD4＋T lymphocyte count（x2=7.757,P=0.021）.Conclusions The major reasons for superficial lymphadenectasis in HIV/AIDS patients are infectious diseases,such as tuberculosis and fungal infections,which are common in patients with lower CD4＋T lymphocyte counts.Non-Hodgkin lymphoma is the most common malignant tumor in this patient population.

关 键 词：HIV感染 获得性免疫缺陷综合征 淋巴系统疾病 结核 真菌病 

分 类 号：R512.91[医药卫生—内科学]