伴神经系统受损的组织细胞坏死性淋巴结炎一例报道并文献复习  

Histiocytic Necrotizing Lymphadenitis with Nervous System Damage:a Case Report and Literature Review

作　　者：徐秀红 李波 马浩源 周毅 矫树生 程晓芳 陈立平 刘久志 智建霞 赵莉 XU Xiuhong;LI Bo;MA Haoyuan;ZHOU Yi;JIAO Shusheng;CHENG Xiaofang;CHEN Liping;LIU Jiuzhi;ZHI Jianxia;ZHAO Li(Department of Neurology,980 Hospital of PLA Joint Logistics Support Forces,Shijiazhuang 050082,China;Department of Neurology,Shijiazhuang People's Hospital,Shijiazhuang 050000,China)

机构地区：[1]解放军联勤保障部队第九八〇医院神经内科,河北省石家庄市050082 [2]河北省石家庄市人民医院神经内三科,050000

出　　处：《实用心脑肺血管病杂志》2022年第6期131-135,140,共6页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

摘　　要：组织细胞坏死性淋巴结炎(HNL)为少见疾病,伴神经系统受损的HNL临床更为罕见。本文报道1例主因“发热11 d”收住院的中年男性患者,入院第3天出现神经系统症状,考虑为“急性脑梗死”,经颈部淋巴结穿刺活检病理检查及免疫组织化学染色检查确诊为HNL,给予糖皮质激素治疗后体温恢复正常。提示,对于发热、淋巴结肿大的患者,其出现神经系统受损时诊断脑梗死应谨慎,需考虑HNL可能,应尽早行淋巴结穿刺活检以明确诊断,且应用糖皮质激素等药物综合治疗是改善患者预后的关键。Histiocytic necrotizing lymphadenitis(HNL)is a rare disease,and HNL with nervous system damage is even rarer in clinical practice.In this report,a middle aged male patient hospitalized with fever for 11 days and developed neurological symptoms and signs on the third day and was diagnosed with"acute cerebral infarction".The patient was confirmed with HNL by pathological.After treatment with glucocorticoids biopsy and immunohistochemical staining of cervical lymph,the patient's temperature returned to normal.Even with nervous system damage,the diagnosis of acute cerebral infarction should be made cautiously in patients with fever and lymphadenopathy and the possibility of HNL should be taken into account.Lymph node biopsy should be performed as soon as possible to confirm the diagnosis.The combined application of glucocorticoids and other drugs is the key to improve the prognosis of patients.

关 键 词：组织细胞坏死性淋巴结炎 脑梗死 误诊 病例报告 

分 类 号：R551.2[医药卫生—血液循环系统疾病]