巨淋巴结增生症无症状者在成人和儿童都可发生。合并顽固性贫血和免疫学方面异常的约不足10%,见于20岁以下的患者。纵隔巨淋巴结增生合并贫血及免疫学异常出现于儿童患者。作者报告了一例经手术及随访20年的纵隔巨淋巴结增生合高丙球蛋白血症和贫血的病例,报告的患者为女性,14岁。临床上有生长缓慢,青春期发育延迟以及发热、关节痛、血沉增速等表现。胸部X 线检查见右上纵隔有7.5×5厘米的肿物。该阴影位于锁骨与第六肋骨起始部之间,在右主支气管上方气管及食管旁。化验见有血丙球蛋白增多及贫血。铁剂治疗对贫血无效。手术切除纵隔肿物之后病人生长及第二性征的发育均正常,其它症状也消失。随访观察20年仅发现有代偿性增多的红细胞溶血现象及血清JgM 含量增高。病理所见肿物有包膜,重69克,大小为7.5×6×4厘米。组织学检查见很多淋巴沪泡在其生发中心周围的成 Asymptomatic giant lymph node hyperplasia in adults and children can occur. Less than 10% of patients with anorexia and immunology abnormalities are found in patients under 20 years of age. Mediastinal lymph node hyperplasia with anemia and immunological abnormalities appear in children. The authors reported a case of hypermegalococcal hyperplasia and anemia after surgery and follow-up of 20 years with mediastinal giant lymph nodes. The reported patients were female, 14 years old. Clinical slow growth, delayed puberty and fever, joint pain, ESR and other performance. Chest X-ray examination see the right upper mediastinum with 7.5 × 5 cm tumor. The shadow is located between the clavicle and the beginning of the sixth rib in the right main bronchus and trachea. Laboratory tests showed increased blood globulin and anemia. Iron therapy is not effective on anemia. After the surgical removal of mediastinal masses, the patient’s growth and the development of secondary sexual characteristics were normal, and other symptoms disappeared. Followed up for 20 years only found compensatory increase in hemolysis of red blood cells and serum JgM increased. Pathological findings of the tumor capsule, weighing 69 grams, the size of 7.5 × 6 × 4 cm. Histological examination found a lot of lymphatic bubble in its germinal center around into