摘要
目的探讨传染性单核细胞增多症淋巴结病(LIM)的临床特点。方法采用免疫组化及原位杂交方法并结合临床资料分析LIM的临床特点、实验室检查结果、EBV感染情况及免疫表型。结果临床特点:患者均为青少年(平均年龄19岁),起病急,病程短(平均病程18天),发热,淋巴结肿大,短期自愈。实验室检查:血常规中单核细胞比例及绝对值增高,肝功能异常,外周血异型淋巴细胞增多,EBV抗体阳性。镜检:淋巴结基本结构不同程度破坏,斑驳状,无包膜增厚及间质纤维增生。免疫组化:CD30并且CD20(+)的免疫母细胞散在分布,强弱不等。4例标本原位杂交EBER均(+)。结论 LIM是EBV感染引起的青少年自限性淋巴组织增生性疾病。诊断时需综合临床特点、实验室检查、EBV感染及免疫表型多方面因素,以免过诊断。
Purpose To discuss the clinical features,laboratory examination,EBV infection and immunohistochemical features of infectious mononucleosis（ LIM） to enhance the knowlage of the diagnosis and differential diagnosis. Methods Immunohistochemistry and EBER in situ hybridization together with clinical data analysis were used to analyze the clinical features,morphology,immunophenotype and EBV infection status of LIM. Results Clinically,patients were all young,and average age was 19 years old. The average suffering duration was 18 days. It was an acute disease with fever and lymphadenopathy. Most of the patients had a rapid recovery. Laboratory examination showed that the ratio of monocytes was increased. Liver function index was abnormal. Abnormal lymphocyte was increased. EBV antibody was positive.Microscopically,the normal architecture of the involved lymph nodes was partially destroyed,and interfollicular and paracortical areas were infiltrated by numerous large lymphoid cells. There were no capsule thickening of the lymph node and fibrosis. Immunohistochemically,the large lymphoid cells in the four cases were positive for CD30 and CD20 with variable intensity signal. EBER of the four cases were all positive. Conclusions LIM is an EBV-related acute selfrecovering lymphoproliferative disease. Taking clinical characteristics,morphology,EBV infection and immunophenotype into considerations will help correct diagnoses.
出处
《诊断病理学杂志》
CSCD
2015年第10期614-616,620,共4页
Chinese Journal of Diagnostic Pathology
