组织细胞坏死性淋巴结炎临床分析
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摘要
目的：
对组织细胞坏死性淋巴结炎进行临床分析,包括命名、发病情况、病因机制、临床表现、辅助检查、病理、诊断与鉴别诊断、治疗与预后。旨在提高对该病的认识,以提高临床诊治率。方法：
结合所见临床病例,检索复习相关文献,分析组织细胞坏死性淋巴结炎各方面情况。
结论：
组织细胞坏死性淋巴结炎(HNL)又称坏死性淋巴结炎,病毒性淋巴结炎,亚急性淋巴结炎及KiKuchi Fujimoto病,由日本人Kikuchi和Fujimoto1972年首先报道并命名,是一种主要累及淋巴结的良性、自限性全身性疾病。病因不明,多发于东方青年女性。临床上表现为发热、浅表淋巴结肿大、皮疹等。由于在临床上缺乏特异性表现,且发病率较低,对该病认识不足,在口腔颌面外科的临床诊断中又难与其他淋巴结性疾病相鉴别,易导致误诊、误治。
Objective:
To analyze histiocytic necrotizing lymphadenitis (HNL),including the denominate, epidemiology, etiology, clinical manifestation, auxiliary examination, pathology, diagnosis and differential diagnosis, treatment and prognosis.
Methods:
Combining the repesentative case of histiocytic necrotizing lymphadenitis (HNL), search former literatures and analyze this disease.
Conclusions:
Histiocytic necrotizing lymphadenitis (HNL) is called necrotizing lymphadenitis, virus lymphadenitis, sub-acute lymphadenitis or Kikuchi Fujimoto Disease, which was first reported and denominated by Japanese Kikuchi and Fujimoto in 1972. It is benign, self-control, systematic disease which involves lymph nodes and often happens on young women in the east without clear etiology. Its manifest shows fever, lymphadenectasis, rash and so on. HNL is easily mistakenly treated for absence of specificity, low incidence rate, unfamiliarity with this disease and difficulty identification with other lymph nodes diseases.
对组织细胞坏死性淋巴结炎进行临床分析,包括命名、发病情况、病因机制、临床表现、辅助检查、病理、诊断与鉴别诊断、治疗与预后。旨在提高对该病的认识,以提高临床诊治率。方法：
结合所见临床病例,检索复习相关文献,分析组织细胞坏死性淋巴结炎各方面情况。
结论：
组织细胞坏死性淋巴结炎(HNL)又称坏死性淋巴结炎,病毒性淋巴结炎,亚急性淋巴结炎及KiKuchi Fujimoto病,由日本人Kikuchi和Fujimoto1972年首先报道并命名,是一种主要累及淋巴结的良性、自限性全身性疾病。病因不明,多发于东方青年女性。临床上表现为发热、浅表淋巴结肿大、皮疹等。由于在临床上缺乏特异性表现,且发病率较低,对该病认识不足,在口腔颌面外科的临床诊断中又难与其他淋巴结性疾病相鉴别,易导致误诊、误治。
Objective:
To analyze histiocytic necrotizing lymphadenitis (HNL),including the denominate, epidemiology, etiology, clinical manifestation, auxiliary examination, pathology, diagnosis and differential diagnosis, treatment and prognosis.
Methods:
Combining the repesentative case of histiocytic necrotizing lymphadenitis (HNL), search former literatures and analyze this disease.
Conclusions:
Histiocytic necrotizing lymphadenitis (HNL) is called necrotizing lymphadenitis, virus lymphadenitis, sub-acute lymphadenitis or Kikuchi Fujimoto Disease, which was first reported and denominated by Japanese Kikuchi and Fujimoto in 1972. It is benign, self-control, systematic disease which involves lymph nodes and often happens on young women in the east without clear etiology. Its manifest shows fever, lymphadenectasis, rash and so on. HNL is easily mistakenly treated for absence of specificity, low incidence rate, unfamiliarity with this disease and difficulty identification with other lymph nodes diseases.
引文
[1]郝钢,梁立民,胡敏,常世民,姚玉胜,北京口腔医学,2007,15(2)：111-112
[2]孙荣超,杨树东,张丽华,陈瑛,吴光斌,中国现代医学杂志,2005,15(12)：1862-1864
[3]陈立,韩喜文,中国实用医药,2007,2(19)：88-89
[4]王继华,口腔医学,2005,25(1)：62-63
[5]韦昆成,右江民族医学院学报,2007,29(2)：247
[6]孙桂莲,姜红堃,李萍,中国当代儿科杂志,2005,7(3)：269-270
[7]黄花荣,卖贤弟,曾巧慧,中国当代儿科杂志,2002,4(1)：73-75
[8]孙永馨,王向波,叶静,贾建平,李存江,实用医学杂志,2009,25(11)：1831-1832
[9]孟庆翔,高雄辉,谢景华,国际耳鼻咽喉头颈外科杂志,2006,30(1)：65-66
[10]贾若杭,何向蕾,王爱忠,张宏斌,诊断病理学杂志,2002,9(5)：269-271
[11]张丽芝,王恩华,中国医科大学学报,2006,35(1)：77-78
[12]姜锦贵,王武明,陈建华,现在医药卫生,2004,20(21)：2250-2251
[13]Xavier Bosch, MD, Antonio Guilabert, MD, Rosa Miquel, MD,3and Elias Campo, MD, Enigmatic Kikuchi-Fujimoto Disease, American Society for Clinical Pathology,2004; 122:141-152
[14]倪代华,郭以宝,医学理论与实践.2004,17(11)：1262-1263
[15]徐恩斌,黄宗文,白厚喜,柴林强,实用医学杂志,2006,23(2)：181
[16]Successful treatment of severe Kikuchi's disease with intravenous immunoglobulin, Rheumatology 2006;45:235-237
[17]Systemic juvenile idiopathic arthritis, Kikuchi's disease and haemophagocytic lymphohistiocytosis, Rheumatology 2004;43:254
[18]徐立勤,韩咏梅,李永伟,孙德本,中华内科杂志,2006,45(2)：127-129
[19]张宏图,孙耕田,李爱东,刘复生,诊断病理学杂志,2002,9(6)：331-333
[20]朱辉,李美荣,中国误诊学杂志,2007,7(6)：1325-1326
[21]Systemic juvenile idiopathic arthritis, Kikuchi's disease and haemophagocytic lymphohistiocytosis-is there a link? Case report and literature review, Rheumatology 2003;42:596-598
[22]Chung-Wu Lin, MD, PhD, Chia-Liang Chang, Chi-Cheng Li, MD, Yue-hua Chen, Wei-Hsiang Lee, MS, and Su-Ming Hsu, MD, Spontaneous Regression of Kikuchi ymphadenopathy With Oligoclonal T-Cell Populations Favors a Benign Immune Reaction Over a T-Cell Lymphoma, Am J Clin Pathol 2002;117:627-635
[23]M J BENNIE, MRCP, FRCR, K M BOWLES, MRCP and S C RANKIN, MRCP, FRCR, Case report Necrotizing cervical lymphadenopathy caused by Kikuchi-Fujimoto disease, The British Journal of Radiology,76 (2003),656-658
[24]S. David Hudnall, MD, Kikuchi-Fujimoto Disease Is Epstein-Barr Virus the Culprit?, Am J Clin Pathol 2000;113:761-764
[25]Chang-Fang Chiu, MD, PhD, Kuan-Chih Chow, PhD, Tze-Yi Lin, MD, PhD, Ming-Hsui Tsai, MD, Chi-Min Shih, MD, and Li-Mien Chen, MD, Virus Infection in Patients With histiocytic Necrotizing Lymphadenitis in Taiwan, Am J Clin Pathol 2000;113:774-781
[26]Arthritis as an unusual manifestation of Kikuchi-Fujimoto disease, Rheumatology 2003;42:1010-1012
[27]张初吉,于东明,北京急诊医学学术年会论文汇编,2006：178-179
[28]张荣,实用医技杂志,2006,13(7)：1214-1215
[29]芩玉兰,右江民族医学院学报,2009,31(3)：394-395
[30]Bilateral anterior uveitis as an unusual manifestation of Kikuchi-Fujimoto disease, Rheumatology 2004;43:1056-1057
[31]Ju-Young Chung, Sang Woo Kim, Tae Hee Han and Sung Jig Lim, Detection of the Bartonella henselae Gene Sequence in Lymph Nodes of Children With Kikuchi's Disease, Pediatrics 2005; 115; 1112
[32]肖宏,疑难病杂志,2008,7(3)：179
[33]刘丽娟,中国误诊学杂志,2007,7(24)：5942
[34]黄宏宇,程又鹏,陈蕊,口腔医学,2007,27(12)：657
[35]任少华,中国危重病急救医学,2001,13(5)：313-315
[36]徐章伦,肖奇,张木根,谢明水,临床军医杂志,2007,35(1)：157
[37]Stefano A. Pileri,*Fabio Facchetti, Stefano Ascani,*Elena Sabattini, Simonetta Poggi, Milena Piccioli, Damiano Rondelli, Federica Vergoni, Pier. Luigi Zinzani,*Pier Paolo Piccaluga, Brunangelo Falini,(?)and Peter G. Isaacson, Myeloperoxidase Expression by Histiocytes in Kikuchi's and Kikuchi-Like Lymphadenopathy, American Journal of Pathology, Vol.159, No.3, September 2001
[38]Hsin-Ching Lin, Chih-Ying Su and Shun-Chen Huang, Kikuchi's Disease in Asian Children, Pediatrics 2005;115;e92-e96
[39]胡贤主,米建新,戚好文,临床误诊误治,2000,13(6)：446
[40]许文剑,吕进军,内蒙古医学杂志,2005,37(10)：972
[41]张广龙,罕少疾病杂志,2005,12(1)：54
[42]Disease With Prolonged Fever in Children, Pediatrics 2004;114;e752-e756; originally published online Nov 15,2004;
[43]宋邵华,王雅杰,孙武装,现代中西医结合杂志,2006,15(23)：3260-3261
[44]刘秀英,中国现代医学杂志,2005,15(1)：84-85
[45]张进,山东医药,2005,45(16)：46
[46]张妮,李兴福,刘花香,中华风湿病学杂志,2006,10(2)：124-125
[47]Rogerio Gastal Xavierl, Denise Rossato Silva, Mauro Waldemar Keiserman, Maria Francisca Torres Lopes, Kikuchi-Fujimoto disease, J Bras Pneumol. 2008;34(12):1074-1078
[48]周云芳,中国小儿血液,2005,10(2)：92-95
[49]吕文才,付维利,谭文翔,中国误诊学杂志,2006,6(1)：163-164
[50]杨二杨,吴剑琴,江西医药,2005,40(3)：154-155
[51]程若倩,徐虹,实用儿科临床杂志,2005,1(20)：33-34
[52]William J Primrose1, Seamus S Napier2, Alyson J Primrose1, Kikuchi-Fugimoto Disease (Cervical Subacute Necrotising Lymphadenitis):An important benign disease often masquerading as lymphoma, Ulster Med J 2009;78(2):134-136
[53]R W Blewitt, S N Kumar, J S Abraham, Recurrence of Kikuchi's lymphadenitis after 12 years, JClin Pathol 2000;53:157-158
[54]U Mahadeva, T Allport, B Bain,W K Chan, Haemophagocytic syndrome and histiocytic necrotising lymphadenitis (Kikuchi's disease), J Clin Pathol 2000;53:636-638
[1]王继华,口腔医学,2005,25(1)：62-63
[2]韦昆成,右江民族医学院学报,2007,29(2)：247
[3]孙桂莲,姜红堃,李萍,中国当代儿科杂志,2005,7(3)：269-270
[4]黄花荣,卖贤弟,曾巧慧,中国当代儿科杂志,2002,4(1)：73-75
[5]孙永馨,王向波,叶静,贾建平,李存江,实用医学杂志,2009,25(11)：1831-1832
[6]孟庆翔,高雄辉,谢景华,国际耳鼻咽喉头颈外科杂志,2006,30(1)：65-66
[7]贾若杭,何向蕾,王爱忠,张宏斌,诊断病理学杂志,2002,9(5)：269-271
[8]朱辉,李美荣,中国误诊学杂志,2007,7(6)：1325-1326
[9]Systemic juvenile idiopathic arthritis, Kikuchi's disease and haemophagocytic lymphohistiocytosis-is there a link? Case report and literature review, Rheumatology 2003;42:596-598
[10]Chung-Wu Lin, MD, PhD, Chia-Liang Chang, Chi-Cheng Li, MD, Yue-hua Chen,Wei-Hsiang Lee, MS, and Su-Ming Hsu, MD, Spontaneous Regression of Kikuchi ymphadenopathy With Oligoclonal T-Cell Populations Favors a Benign Immune Reaction Over a T-Cell Lymphoma, Am J Clin Pathol 2002; 117:627-635
[11]M J BENNIE, MRCP, FRCR, K M BOWLES, MRCP and S C RANKIN, MRCP, FRCR, Case report Necrotizing cervical lymphadenopathy caused by Kikuchi-Fujimoto disease, The British Journal of Radiology,76 (2003),656-658
[12]S. David Hudnall, MD, Kikuchi-Fujimoto Disease Is Epstein-Barr Virus the Culprit?, Am J Clin Pathol 2000; 113:761-764
[13]Chang-Fang Chiu, MD, PhD, Kuan-Chih Chow, PhD, Tze-Yi Lin, MD, PhD, Ming-Hsui Tsai, MD,Chi-Min Shih, MD, and Li-Mien Chen, MD, Virus Infection in Patients With histiocytic Necrotizing Lymphadenitis in Taiwan, Am J Clin
Pathol 2000; 113:774-781
[14]Arthritis as an unusual manifestation of Kikuchi-Fujimoto disease, Rheumatology 2003;42:1010-1012
[15]张初吉,于东明,北京急诊医学学术年会论文汇编,2006：178-179
[16]张荣,实用医技杂志,2006,13(7)：1214-1215
[17]芩玉兰,右江民族医学院学报,2009,31(3)：394-395
[18]Bilateral anterior uveitis as an unusual manifestation of Kikuchi-Fujimoto disease, Rheumatology 2004;43:1056-1057
[19]徐章伦,肖奇,张木根,谢明水,临床军医杂志,2007,35(1)：157
[20]Disease With Prolonged Fever in Children, Pediatrics 2004;114;e752-e756; originally published online Nov 15,2004;
[21]宋邵华,王雅杰,孙武装,现代中西医结合杂志,2006,15(23)：3260-3261
[22]刘秀英,中国现代医学杂志,2005,15(1)：84-85
[23]张进,山东医药,2005,45(16)：46
[24]张妮,李兴福,刘花香,中华风湿病学杂志,2006,10(2)：124-125
[25]杨二杨,吴剑琴,江西医药,2005,40(3)：154-155
[26]程若倩,徐虹,实用儿科临床杂志,2005,1(20)：33-34
[27]William J Primrose1, Seamus S Napier2, Alyson J Primrose1, Kikuchi-Fugimoto Disease (Cervical Subacute Necrotising Lymphadenitis):An important benign disease often masquerading as lymphoma, Ulster Med J 2009;78(2):134-136
[28]R W Blewitt, S N Kumar, J S Abraham, Recurrence of Kikuchi's lymphadenitis after 12 years, J Clin Pathol 2000;53:157-158
[29]U Mahadeva, T Allport, B Bain,W K Chan, Haemophagocytic syndrome and histiocytic necrotising lymphadenitis (Kikuchi's disease), J Clin Pathol 2000;53:636-638
[2]孙荣超,杨树东,张丽华,陈瑛,吴光斌,中国现代医学杂志,2005,15(12)：1862-1864
[3]陈立,韩喜文,中国实用医药,2007,2(19)：88-89
[4]王继华,口腔医学,2005,25(1)：62-63
[5]韦昆成,右江民族医学院学报,2007,29(2)：247
[6]孙桂莲,姜红堃,李萍,中国当代儿科杂志,2005,7(3)：269-270
[7]黄花荣,卖贤弟,曾巧慧,中国当代儿科杂志,2002,4(1)：73-75
[8]孙永馨,王向波,叶静,贾建平,李存江,实用医学杂志,2009,25(11)：1831-1832
[9]孟庆翔,高雄辉,谢景华,国际耳鼻咽喉头颈外科杂志,2006,30(1)：65-66
[10]贾若杭,何向蕾,王爱忠,张宏斌,诊断病理学杂志,2002,9(5)：269-271
[11]张丽芝,王恩华,中国医科大学学报,2006,35(1)：77-78
[12]姜锦贵,王武明,陈建华,现在医药卫生,2004,20(21)：2250-2251
[13]Xavier Bosch, MD, Antonio Guilabert, MD, Rosa Miquel, MD,3and Elias Campo, MD, Enigmatic Kikuchi-Fujimoto Disease, American Society for Clinical Pathology,2004; 122:141-152
[14]倪代华,郭以宝,医学理论与实践.2004,17(11)：1262-1263
[15]徐恩斌,黄宗文,白厚喜,柴林强,实用医学杂志,2006,23(2)：181
[16]Successful treatment of severe Kikuchi's disease with intravenous immunoglobulin, Rheumatology 2006;45:235-237
[17]Systemic juvenile idiopathic arthritis, Kikuchi's disease and haemophagocytic lymphohistiocytosis, Rheumatology 2004;43:254
[18]徐立勤,韩咏梅,李永伟,孙德本,中华内科杂志,2006,45(2)：127-129
[19]张宏图,孙耕田,李爱东,刘复生,诊断病理学杂志,2002,9(6)：331-333
[20]朱辉,李美荣,中国误诊学杂志,2007,7(6)：1325-1326
[21]Systemic juvenile idiopathic arthritis, Kikuchi's disease and haemophagocytic lymphohistiocytosis-is there a link? Case report and literature review, Rheumatology 2003;42:596-598
[22]Chung-Wu Lin, MD, PhD, Chia-Liang Chang, Chi-Cheng Li, MD, Yue-hua Chen, Wei-Hsiang Lee, MS, and Su-Ming Hsu, MD, Spontaneous Regression of Kikuchi ymphadenopathy With Oligoclonal T-Cell Populations Favors a Benign Immune Reaction Over a T-Cell Lymphoma, Am J Clin Pathol 2002;117:627-635
[23]M J BENNIE, MRCP, FRCR, K M BOWLES, MRCP and S C RANKIN, MRCP, FRCR, Case report Necrotizing cervical lymphadenopathy caused by Kikuchi-Fujimoto disease, The British Journal of Radiology,76 (2003),656-658
[24]S. David Hudnall, MD, Kikuchi-Fujimoto Disease Is Epstein-Barr Virus the Culprit?, Am J Clin Pathol 2000;113:761-764
[25]Chang-Fang Chiu, MD, PhD, Kuan-Chih Chow, PhD, Tze-Yi Lin, MD, PhD, Ming-Hsui Tsai, MD, Chi-Min Shih, MD, and Li-Mien Chen, MD, Virus Infection in Patients With histiocytic Necrotizing Lymphadenitis in Taiwan, Am J Clin Pathol 2000;113:774-781
[26]Arthritis as an unusual manifestation of Kikuchi-Fujimoto disease, Rheumatology 2003;42:1010-1012
[27]张初吉,于东明,北京急诊医学学术年会论文汇编,2006：178-179
[28]张荣,实用医技杂志,2006,13(7)：1214-1215
[29]芩玉兰,右江民族医学院学报,2009,31(3)：394-395
[30]Bilateral anterior uveitis as an unusual manifestation of Kikuchi-Fujimoto disease, Rheumatology 2004;43:1056-1057
[31]Ju-Young Chung, Sang Woo Kim, Tae Hee Han and Sung Jig Lim, Detection of the Bartonella henselae Gene Sequence in Lymph Nodes of Children With Kikuchi's Disease, Pediatrics 2005; 115; 1112
[32]肖宏,疑难病杂志,2008,7(3)：179
[33]刘丽娟,中国误诊学杂志,2007,7(24)：5942
[34]黄宏宇,程又鹏,陈蕊,口腔医学,2007,27(12)：657
[35]任少华,中国危重病急救医学,2001,13(5)：313-315
[36]徐章伦,肖奇,张木根,谢明水,临床军医杂志,2007,35(1)：157
[37]Stefano A. Pileri,*Fabio Facchetti, Stefano Ascani,*Elena Sabattini, Simonetta Poggi, Milena Piccioli, Damiano Rondelli, Federica Vergoni, Pier. Luigi Zinzani,*Pier Paolo Piccaluga, Brunangelo Falini,(?)and Peter G. Isaacson, Myeloperoxidase Expression by Histiocytes in Kikuchi's and Kikuchi-Like Lymphadenopathy, American Journal of Pathology, Vol.159, No.3, September 2001
[38]Hsin-Ching Lin, Chih-Ying Su and Shun-Chen Huang, Kikuchi's Disease in Asian Children, Pediatrics 2005;115;e92-e96
[39]胡贤主,米建新,戚好文,临床误诊误治,2000,13(6)：446
[40]许文剑,吕进军,内蒙古医学杂志,2005,37(10)：972
[41]张广龙,罕少疾病杂志,2005,12(1)：54
[42]Disease With Prolonged Fever in Children, Pediatrics 2004;114;e752-e756; originally published online Nov 15,2004;
[43]宋邵华,王雅杰,孙武装,现代中西医结合杂志,2006,15(23)：3260-3261
[44]刘秀英,中国现代医学杂志,2005,15(1)：84-85
[45]张进,山东医药,2005,45(16)：46
[46]张妮,李兴福,刘花香,中华风湿病学杂志,2006,10(2)：124-125
[47]Rogerio Gastal Xavierl, Denise Rossato Silva, Mauro Waldemar Keiserman, Maria Francisca Torres Lopes, Kikuchi-Fujimoto disease, J Bras Pneumol. 2008;34(12):1074-1078
[48]周云芳,中国小儿血液,2005,10(2)：92-95
[49]吕文才,付维利,谭文翔,中国误诊学杂志,2006,6(1)：163-164
[50]杨二杨,吴剑琴,江西医药,2005,40(3)：154-155
[51]程若倩,徐虹,实用儿科临床杂志,2005,1(20)：33-34
[52]William J Primrose1, Seamus S Napier2, Alyson J Primrose1, Kikuchi-Fugimoto Disease (Cervical Subacute Necrotising Lymphadenitis):An important benign disease often masquerading as lymphoma, Ulster Med J 2009;78(2):134-136
[53]R W Blewitt, S N Kumar, J S Abraham, Recurrence of Kikuchi's lymphadenitis after 12 years, JClin Pathol 2000;53:157-158
[54]U Mahadeva, T Allport, B Bain,W K Chan, Haemophagocytic syndrome and histiocytic necrotising lymphadenitis (Kikuchi's disease), J Clin Pathol 2000;53:636-638
[1]王继华,口腔医学,2005,25(1)：62-63
[2]韦昆成,右江民族医学院学报,2007,29(2)：247
[3]孙桂莲,姜红堃,李萍,中国当代儿科杂志,2005,7(3)：269-270
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