IgG4相关性硬化性涎腺炎7例临床病理分析  

IgG4-related sclerosing sialadenitis: a clinicopathological analysis of 7 cases

作　　者：冯晓星[1] 余波[1] 何燕[1] 张新华[1] 周晓军[1] 

机构地区：[1]南京军区南京总医院病理科,南京210002

出　　处：《诊断病理学杂志》2014年第8期472-475,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的分析IgG4相关性硬化性涎腺炎的组织病理学特征,并探讨其可靠的诊断指标。方法从以往诊断为慢性硬化性涎腺炎和Kuttner瘤的病例中筛选出有明显淋巴浆细胞浸润的病例,运用免疫组化EnVision二步法标记IgG及IgG4阳性的淋巴浆细胞,并分析其含量;对符合IgG4相关性硬化性涎腺炎的病例观察其临床病理学特征。结果 27例中共筛选出符合IgG4相关性硬化性涎腺炎诊断标准的病例共7例,7例组织病理学均表现为腺泡萎缩,间质纤维化伴有大量淋巴浆细胞浸润,免疫组化标记IgG4阳性浆细胞>50个/HPF,IgG4/IgG阳性浆细胞之比>0.4。结论 IgG4相关性硬化性涎腺炎是一种主要累及颌下腺的炎性病变,唾液腺组织硬化和大量淋巴细胞和浆细胞浸润是其主要组织学特征,免疫组化显示组织内有大量或高比例IgG4阳性浆细胞浸润是确诊的重要指标。Objective To analyze the histopathological features of IgG4-related sclerosing sialadenitis and to discuss the possible criteria for its diagnosis. Methods We collected 27 cases of diagnosed chronic sialadenitis and Kuttner＇s tumor from our files, using immumohistochemical technique to detect the IgG and IgG4 positive plasmacytes,and to count their numbers. Results 7 of 27 cases met the diagnostic criteria, the histopathological features of the 7 cases showed acinar atrophy, interstitial fibrosis and massive lymphoplasmacytic infiltration, immunohistochemical stain showed IgG4＋ plasma cells 〉 50/HPF, and IgG4＋/ IgG＋ plasma cells 〉 0. 4. Conclusions IgG4-related sclerosing sialadenitis is aninflammatory disease which involves the submandibular gland in most instances. Salivary gland tissue fibrosis with plentiful lymphocytes and plasmacytes infiltration is the main histological features. Immunohistochemical staining shows that a large number or a high proportion of IgG4＋ plasma cells in the tissue is a crucial diagnostic criterion.

关 键 词：慢性硬化性颌下腺炎 IgG-4相关性硬化性疾病 诊断 

分 类 号：R737.9[医药卫生—肿瘤]