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目的分析IgG4相关性硬化性涎腺炎的组织病理学特征,并探讨其可靠的诊断指标。方法从以往诊断为慢性硬化性涎腺炎和Kuttner瘤的病例中筛选出有明显淋巴浆细胞浸润的病例,运用免疫组化EnVision二步法标记IgG及IgG4阳性的淋巴浆细胞,并分析其含量;对符合IgG4相关性硬化性涎腺炎的病例观察其临床病理学特征。结果 27例中共筛选出符合IgG4相关性硬化性涎腺炎诊断标准的病例共7例,7例组织病理学均表现为腺泡萎缩,间质纤维化伴有大量淋巴浆细胞浸润,免疫组化标记IgG4阳性浆细胞>50个/HPF,IgG4/IgG阳性浆细胞之比>0.4。结论 IgG4相关性硬化性涎腺炎是一种主要累及颌下腺的炎性病变,唾液腺组织硬化和大量淋巴细胞和浆细胞浸润是其主要组织学特征,免疫组化显示组织内有大量或高比例IgG4阳性浆细胞浸润是确诊的重要指标。
Objective To analyze the histopathological features of IgG4-related sclerosing sialadenitis and to discuss its reliable diagnostic criteria. Methods From the previous diagnosis of chronic sclerosing sarcoma and Kuttner tumor cases were screened cases of significant lymphocyte infiltration, the use of immunohistochemical EnVision two-step labeling of IgG and IgG4-positive lymphocytes, and analysis of its content The clinicopathological features were observed in patients with IgG4-related sclerosing gland sarcoma. Results A total of 7 cases of IgG4 sclerosing sialadenitis were screened out in 27 cases. The histopathology of 7 cases showed acinar atrophy, interstitial fibrosis with a large number of infiltration of lymphocytes and immunohistochemistry Marked IgG4 positive plasma cells> 50 / HPF, IgG4 / IgG positive plasma cells ratio> 0.4. Conclusions IgG4-related sclerosing sialadenitis is an inflammatory disease mainly involving the submandibular gland. Histology of salivary gland tissue sclerosis and infiltration of numerous lymphocytes and plasma cells is the main histological feature. Immunohistochemistry showed that a large number or high proportion of IgG4 Positive plasma cell infiltration is an important indicator of diagnosis.