儿童组织细胞坏死性淋巴结炎38例分析  

Clinical analysis of 38 cases with histiocytic necrotizing lymphadenitis in children

作　　者：罗丽娟 曹清 周云芳[1] 王希华 王薇[1] Luo Lijuan Cao Qing Zhou Yunfang Wang Xihua Wang Wei.(Department of Infectious Disease,Shanghai Children＇s Medical Center Affilicated to Shanghai Jiaotong University School of Medicine, Shanghai 200127, China)

机构地区：[1]上海交通大学医学院附属上海儿童医学中心感染科,200127

出　　处：《中国小儿急救医学》2017年第9期677-679,685,共4页Chinese Pediatric Emergency Medicine

摘　　要：目的 探讨儿童组织细胞坏死性淋巴结炎（HNL）的临床病理特点。方法 回顾性分析2000年6月至2015年5月期间于我院诊断HNL的38例患儿的临床及病理资料。结果 HNL以学龄期儿童为主，男女比例为1.4∶1，临床表现主要为：淋巴结肿大（100%）、发热（68.24%）、白细胞降低（52.63%）及淋巴细胞比例上升（84.21%）。全部患儿进行淋巴结切除活检均符合HNL。部分患儿（31.58%）自发缓解，部分患儿应用非甾体类抗炎药、糖皮质激素及丙种球蛋白治疗，治疗效果满意。暂未见复发及并发其他自身免疫性疾病。结论 HNL有一定的临床特征，但缺乏特异性，明确诊断需依靠淋巴结活检；HNL是一类良性、自限性疾病，有一定的自发缓解率，激素、非甾体类抗炎药及丙种球蛋白治疗效果满意，需长期随访。Objective To study the clinical and pathological features of histiocytic necmtizing lym- phadenitis（HNL） in children. Methods The clinical data and histological findings of 38 cases of HNL admitted in our hospital from June 2000 to May 2015 were reviewed. Results Most of the patients were school-age children with male-femal ratio of 1.4： 1. The main clinical features were lymphadenopathy （ 100% ）, fever （ 68. 24 % ）, leucocytopenia （ 52. 63 % ）, rising of lymphocytes percentage （ 84. 21% ）. All of the lymph node excisional biopsy met the criterion of HNL. Some cases spontaneously relieved and some cases were treated with NSAID, glucocorticoid or immunoglobulin and benefited significantly. There was no recurrence. Conclusion The clinical situation is not specific. The diagnosis is established by lymph node ex- cisional biopsy. HNL is benign and self-limited disease. The effect of management using glucocorticoid, NSAID and immunoglobulin is remarkable. Long term follow-up is necessary.

关 键 词：组织细胞坏死性淋巴结炎 临床表现 活组织检查 治疗 预后 

分 类 号：R725.9[医药卫生—儿科]