INFLAMMATORY PSEUDOTUMOR OF LYMPH-NODES - ADDITIONAL OBSERVATIONS AND EVIDENCE FOR AN INFLAMMATORY ETIOLOGY
INFLAMMATORY PSEUDOTUMOR OF LYMPH-NODES - ADDITIONAL OBSERVATIONS AND EVIDENCE FOR AN INFLAMMATORY ETIOLOGY
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DOI：
10.1097/00000478-199108000-00004
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发表时间：
1991-08-01
影响因子：
5.6
通讯作者：
DORFMAN, RF
中科院分区：
文献类型：
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作者：
DAVIS, RE;WARNKE, RA;DORFMAN, RF
淋巴结炎性假瘤。一个最近描述的良性原因淋巴结病，研究了14例患者使用石蜡切片免疫组织化学。所有活检均显示梭形细胞（小血管、组织细胞）增殖。和类似于肌成纤维细胞的“活化的”成纤维细胞），其含有炎性细胞的混合物而不具有淋巴结，并涉及淋巴结的结缔组织框架（门和窦）。10例患者具有最初描述的IPT的其他组织学特征（结节性扩展、闭塞性血管炎和内皮浸润），其中9例患者伴有不明原因的发热，其中一些患者仅通过活检缓解。在某些病例中观察到局灶性但先前未描述的其他特征包括淋巴结实质梗死、纤维素样血管坏死、核破裂和仅累及部分淋巴结。免疫染色显示淋巴浸润主要是T细胞（浆细胞除外），只有少数标记为T辅助细胞。许多单核细胞类似组织细胞被确定，其中一些有一个纺锤形的形状，但与抗体（KP 1）的骨髓单核细胞特异性反应。大成纤维细胞表达α-肌肉肌动蛋白，但不表达结蛋白。类似于肉芽组织中的肌成纤维细胞。形态学和免疫组织学特征与脾脏和肝脏炎性假瘤相似，但缺乏同时淋巴结受累反对共同的病因。结果表明，IPT的肿块病变是对局部淋巴结炎症或损伤的反应，进一步排除了血淋巴样瘤或间质瘤的原因。
Inflammatory pseudotumor of lymph nodes (IPT). a recently described benign cause of lymphadenopathy, was studied in 14 patients using paraffin-section immunohistochemistry. All biopsies showed a proliferation of spindle cells (small blood vessels, histiocytes. and "activated" fibroblasts resembling myofibroblasts) containing a mixture of inflammatory cells without atypia and involving the connective tissue framework (hilum and sinuses) of the lymph node. Ten patients had additional histologic features of IPT originally described (extranodal extension, obliterative vasculitis, and endothelial infiltration), and nine of these had associated fever of unknown origin, which in some was relieved by biopsy alone. Additional features observed focally in some cases but not previously described included lymph node parenchymal infarction, fibrinoid vascular necrosis, karyorrhexis, and involvement of only part of the lymph node. Immunostaining showed the lymphoid infiltrate to be predominantly of T-lineage (except for plasma cells), only a minority of which marked as T-helper cells. Numerous mononuclear cells resembling histiocytes were identified, some of which had a spindled shape but reacted with an antibody (KP1) of myelomonocytic specificity. Large fibroblastic cells expressed alpha-muscle actin but not desmin. similar to myofibroblasts in granulation tissue. The morphologic and immunohistologic features were similar to those in inflammatory pseudotumors of spleens and livers also studied, but the lack of simultaneous lymph node involvement argued against a common etiology. The findings suggest that the mass lesion of IPT is produced in response to localized lymph node inflammation or injury and further exclude hematolymphoid or mesenchymal neoplasia as a cause.