乳腺Rosai-Dorfman病4例临床病理分析  

Rosai-Dorfman disease in the breast:a clinicopathologic analysis of four cases

作　　者：刘梅[1] 李席如[2] 李瑛[3] 程流泉[4] 郑一琼[2] 宋欣[1] 吴蕴 

机构地区：[1]解放军总医院病理科,北京100853 [2]解放军总医院普外科,北京100853 [3]解放军总医院肿瘤科,北京100853 [4]解放军总医院放射科,北京100853 [5]德州大学MD安德森癌症中心病理科,美国休斯敦tx77030

出　　处：《诊断病理学杂志》2017年第10期725-730,共6页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨Rosai-Dorfman病(RDD)和IgG4相关性疾病(IgG4RD)的关系。方法分析4例乳腺RDD的组织形态特点,并计数病变区IgG4+浆细胞数和IgG4/IgG比值,其中2例还检测了血清IgG4水平。结果 2例(例1和例2)显示IgG4RD的一些形态特点,即伴有退行性变的淋巴滤泡生成、闭塞性静脉炎的存在、间质IgG4+浆细胞数增多和IgG4/IgG比值增高,其中例1血清IgG4水平升高。这2例均存在淀粉样变性,淀粉样物在病变区的间质和静脉壁沉积。另2例(例3和例4)病变区IgG4+浆细胞轻度增多,IgG4/IgG比值无增高,淀粉样物只在病变区的间质沉积。结论乳腺Rosai-Dorfman病可能存在一个与IgG4RD交叉的亚型,可能被诱导出现淀粉样变性。Objective To elucidate the relationship between Rosai-Dorfman disease（RDD） and IgG4-related disease（IgG4RD）.Methods The histological features of 4 cases of RDD in the breast were analyzed and the numbers of IgG4＋ plasma cells and IgG4/IgG ratios were evaluated.Serum IgG4 concentrations were also measured in two of the cases.Results Two cases（cases 1 and 2） showed features of IgG4 RD,including lymphoid follicle formation with regressive changes,obliterative phlebitis,increased number of IgG4＋ plasma cells,and increased IgG4/IgG ratio;Case 1 showed elevated serum IgG4 level.Amyloidosis was detected in the two cases,with amyloid in the stroma and the vessel walls of the lesion.The other 2 cases（cases 3 and 4） only had mild increases in the numbers of IgG4＋ plasma cells without increased IgG4/IgG ratio,while amyloid deposited in the stroma only.Conclusions A subset of RDD may overlap with IgG4 RD in the breast and amyloidosis could be induced in the lesion.

关 键 词：ROSAI-DORFMAN病 IGG4相关性疾病 淀粉样变性 

分 类 号：R737.19[医药卫生—肿瘤]