Abstract：
This study aimed to enhance the histopathological diagnosis of necrotic lymph node specimens. A chart review was conducted, revealing that the most common causes of lymph node necrosis were Kikuchi disease (33%), granulomatous inflammation (25%), metastasis (17%), and lymphomas (12%). Histological analysis of necrotic tissue in 333 specimens demonstrated significant differences between the four diseases. The necrotic tissue of Kikuchi disease was amorphous, and hypercellular, and exhibited karyorrhexis and congestion. Granulomatous inflammation presented amorphous necrotic tissue with a nodular-like pattern. Metastasis exhibited heterogeneous morphology that varied between cancer types. Lymphomas displayed extensive necrosis with ghost cells, congestion, and bubbles. Reticulin staining patterns also differed between diseases. Kikuchi disease and lymphomas exhibited preserved reticular fiber networks in the necrotic tissue, resembling the viable tissue. Granulomatous inflammation and metastasis showed disrupted reticular fiber networks in the necrotic tissue. Based on these findings, histological features and reticulin staining patterns can aid in diagnosing Kikuchi disease, granulomatous inflammation, metastasis, and lymphomas in necrotic lymph node specimens.
摘要：
本研究旨在提高坏死淋巴结标本的组织病理学诊断。进行了图表审查，发现淋巴结坏死的最常见原因是Kikuchi病（33％），肉芽肿性炎症（25%），转移（17%），和淋巴瘤（12%）。333个标本的坏死组织的组织学分析表明这四种疾病之间存在显着差异。Kikuchi病的坏死组织是无定形的，和高细胞，并表现出核仁和充血。肉芽肿性炎症表现为无定形坏死组织，呈结节状。转移表现出异质性形态，在癌症类型之间有所不同。淋巴瘤表现出广泛的坏死与鬼细胞，拥塞，和气泡。网状蛋白染色模式在疾病之间也有所不同。Kikuchi病和淋巴瘤在坏死组织中表现出保留的网状纤维网络，类似于有活力的组织。肉芽肿性炎症和转移显示坏死组织中的网状纤维网络破裂。基于这些发现,组织学特征和网状蛋白染色模式可以帮助诊断菊池病，肉芽肿性炎症,转移,坏死淋巴结标本中的淋巴瘤。
