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目的 探讨淋巴结分支杆菌性梭形细胞假瘤的临床病理特征。方法 对 2例淋巴结分支杆菌性梭形细胞假瘤 ,常规石蜡切片 ,HE、抗酸染色 ,免疫组织化学标记 ,光镜观察。结果 患者均系 1岁婴儿 ,无免疫缺陷疾病和使用免疫抑制剂史 ,出生 1个月后接种卡介苗。临床表现 :腋下淋巴结结节性肿大伴发热 ,病理表现 :淋巴结内梭形细胞束状或席纹状增生伴有淋巴细胞、浆细胞、中性粒细胞浸润和增生的毛细血管 ,形成梭形细胞假瘤。抗酸染色显示病变内大量分支杆菌 ,免疫组织化学标记梭形细胞Mac387和溶菌酶强阳性、S 10 0阴性。结论 在免疫功能低下或缺陷患者 (如AIDS)和婴儿接种卡介苗后 ,可以发生淋巴结分支杆菌性梭形细胞假瘤。该病应与淋巴结的原发性梭形细胞肿瘤鉴别 ,确诊对其治疗十分重要。
Objective To investigate the clinicopathological features of mycobacterium tuberculosis pseudotumor of lymph node. Methods Two cases of Mycobacterium tuberculosis pseudotumor, conventional paraffin section, HE, acid-fast staining, immunohistochemical staining and light microscopy were performed. Results All patients were 1-year-old infants. No immunodeficiency disease and immunosuppressant were used. BCG was inoculated one month after birth. Clinical manifestations: nodular lymph node enlargement with fever, pathological manifestations: spindle-shaped cells in the lymph node or mylar striated hyperplasia accompanied by lymphocytes, plasma cells, neutrophil infiltration and proliferation of capillaries, the formation of fusiform Cell pseudotumor. Acid-fast staining showed that a large number of mycobacteria, immunohistochemical spindle cells Mac387 and lysozyme strongly positive, S 10 0 negative. Conclusion Mycobacterium tuberculosis pseudotumor may develop after immunocompromised or defective patients (such as AIDS) and infants with BCG vaccination. The disease should be differentiated from the primary spindle cell tumor of the lymph node. Diagnosis is very important for its treatment.