华西口腔医学杂志

• 临床研究 • 上一篇    下一篇

颌面部淋巴结反应性增生的临床与病理研究

李志刚1 王霄1 潘向勇1 李敏2 邹士琦1   

  1. 1.北京大学第三医院口腔科; 2.北京大学基础医学院病理学系, 北京100191
  • 收稿日期:2011-04-25 修回日期:2011-04-25 出版日期:2011-04-20 发布日期:2011-04-20
  • 通讯作者: 李志刚,Tel: 010-82266333
  • 作者简介:李志刚(1961—),男,河北人,主任医师,学士

Clinicopathologic study on reactive hyperplasia of lymph nodes in maxillofacial regions

LI Zhi-gang1, WANG Xiao1, PAN Xiang-yong1, LI Min2,ZOU Shi-qi1   

  1. 1. Dept. of Stomatology, The Third Hospital of Peking University, Beijing 100191, China; 2. Dept. of Pathology, Basic Medical School, Peking University, Beijing 100191, China
  • Received:2011-04-25 Revised:2011-04-25 Online:2011-04-20 Published:2011-04-20
  • Contact: LI Zhi-gang,Tel: 010-82266333

摘要:

目的分析颌面部淋巴结反应性增生的临床和病理学表现,以期为治疗提供参考。方法对32例术后病理诊断为淋巴结反应性增生的住院患者进行临床表现、组织形态学和免疫组织化学分析。结果32例患者的组织形态学分别表现为淋巴滤泡增生、边缘区淋巴增生、副皮质区淋巴增生和很少的混合性增生。免疫组织化学表现:23例(72%)为以CD20阳性表达为主的B细胞性淋巴组织增生,7例(22%)为以CD3阳性表达为主的T细胞性淋巴组织增生,2例(6%)为以部分CD20和CD3阳性表达的T、B淋巴细胞和组织细胞混合性增生的淋巴组织增生。10例患者可见细胞的非典型增生。结论颌面部淋巴结反应性增生主要是以CD20阳性表达为主的B细胞性淋巴组织增生。其中的非典型性增生病例有恶性变的可能性,术后应定期复查和密切随访。

关键词: 淋巴结, 反应性增生, 颌面部, 免疫组织化学

Abstract:

Objective To investigate the clinicopatholigic features of reactive hyperplasia of lymph nodes in maxillofacial regions. Methods Thirty-two patients with lymph node reactive hyperplasia(LRH) were analyzed clinicopathologically including pathomorphologic manifestation and immunohistochemical expression. Results Histopathology of 32 patients showed significant hyperplasia in folliculus lymphaticus, marginal zone lymph, paracortical area lymph, and seldom mixed hyperplasia. Immunohistochemical study showed that the hyperplastic lymphocytes were mainly composed of CD20 positive B cells positive in 23 cases(72%), CD3 positive T cell in 7 cases(22%), CD20 positive T cell and CD3 positive B cell partially as well as histiocytes in 2 cases(6%). Atypical hyperplasia was found in 10 cases. Conclusion Hyperplastic lymphocytes in LRH of maxillofacial regions are mainly composed of B cells. Malignant transformation may occur in these patients with atypical hyperplasia. Regularity follow up is necessary for these patients.

Key words: lymph node, reactive hyperplasia, maxillofacial region, immunohistochemistry