嗜酸性淋巴肉芽肿的临床特点和治疗(1)
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[摘要] 目的 分析嗜酸性淋巴肉芽肿的临床病理特点，探讨合理的治疗方案。 方法 对20例经病理学确诊的嗜酸性淋巴肉芽肿患者的临床特点、治疗方法和预后进行回顾性分析。 结果 全组20例患者中男性多见，平均发病年龄39岁；临床上表现为单发或多发的结节性肿块，以腮腺区最为多见(41.4%)。所有患者外周血嗜酸性粒细胞均增高。病理学上表现为淋巴组织增生并形成淋巴滤泡，生发中心极性存在，血管周围及滤泡间大量的嗜酸性粒细胞浸润。行单纯手术治疗的3例患者中有2例复发。 结论 嗜酸性淋巴肉芽肿是一种具有特殊临床和病理表现的慢性炎症性疾病。单纯手术容易复发，手术联合放疗的综合治疗可提高疗效。
[关键词] 嗜酸性淋巴肉芽肿；手术治疗；放射治疗
[中图分类号] R782 [文献标识码] B [文章编号] 1673-9701(2012)01-132-02
Clinical features and treatment of eosinophilic lymphoid granuloma
ZHANG Yingjun HOU Rurong
Department of Radiation Oncology，the Affiliated Zhongshan Hospital of Xiamen University，Xiamen 361004，China
[Abstract] Objective To explore the clinical features and treatment of eosinophilic lymphoid granuloma. Methods Twenty cases of eosinophilic lymphoid granuloma which were diagnosed by pathology were analyzed retrospectively about their clinical features，treatment and prognosis. Results The average age of the 20 patients was 39 years old，and males were more than females.The specimens presented mainly as a single or multiple nodule，most frequently in parotid gland region. The eosinophilic cells had increased in each case. Histopathological examination revealed lymphoid tissue hyperplasis formation of lymphoid follicles with active germinal centres. There was diffuse infiltration of eosinophils in interfollicular and perivascular zones. 2 of 3 patients who selected surgery alone were relapse. Conclusion Eosinophilic lymphoid granuloma is a chronic inflammatory disease which had distinctive clinical and histological features. Surgery alone is easy to relapse,but surgery combined with radiotherapy would improve therapeutic effect.
[Key words] Eosinophilic lymphoid granuloma；Surgery；Radiotherapy
嗜酸性淋巴肉芽肿(eosinophilic lymphoid granuloma，ELG)是一种慢性、良性肉芽肿性疾病，发病率较低，主要累及皮下组织、淋巴结、涎腺等，好发部位为头颈部。我院2002年1月～2011年8月共收治20例嗜酸性淋巴肉芽肿患者，现对其临床特征、治疗和预后情况进行分析。
1 资料与方法
1.1 临床特征
所有病例均经病理证实，其中男16例，女4例，男女之比为4∶1，发病年龄15～69岁，平均38岁。病程4个月～16年，中位病程4.5年。单发病变15例，多发病变5例。发病部位包括腮腺、耳后、面颊、颈部、颌下区、鼻腔、腹股沟，见表1。临床上多表现为缓慢增大的无痛性肿块，边界欠清，质地偏韧，直径1.0～14.0 cm，8例患者出现病变区皮肤增厚、粗糙、瘙痒。所有患者外周血嗜酸性粒细胞均增高，最高达2.9×109/L[正常范围(0.05～0.5)×109/L]；影像学表现无特异性，B超、CT、MRI均表现为肿块密度影。确诊依靠病理结果，可见淋巴结及周围软组织淋巴滤泡增生，生发中心极性存在，套区完整，滤泡内见嗜酸性物质沉积，滤泡间毛细血管及高内皮静脉明显增生，大量嗜酸性粒细胞浸润。
1.2 治疗方法
手术联合放疗11例 ......
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