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中华口腔医学研究杂志(电子版) ›› 2015, Vol. 09 ›› Issue (06) : 474 -477. doi: 10.3877/cma.j.issn.1674-1366.2015.06.007

所属专题: 文献

临床研究

头颈部混合型Rosai-Dorfman病1例及文献分析
梁珩1, 周境1, 陈小华1, 庄泽航1, 胡静1, 刘习强1,()   
  1. 1. 510055 广州,中山大学光华口腔医学院·附属口腔医院,广东省口腔医学重点实验室
  • 收稿日期:2015-06-15 出版日期:2015-12-01
  • 通信作者: 刘习强
  • 基金资助:
    国家自然科学基金(81372885、81172567); 教育部新世纪优秀人才支持计划(NCET-11-0535); 高校基本科研业务经费中山大学青年教师培育项目(12ykpy69)

Nodal and extranodal Rosai-Dorfman disease in head and neck: a case report with literature review

Heng Liang1, Jing Zhou1, Xiaohua Chen1, Zehang Zhuang1, Jing Hu1, Xiqiang Liu1,()   

  1. 1. Guanghua School of Stomatology, Hospital of Stomatology, Sun Yat-sen University, Guangdong Provincial Key Laboratory of Stomatology, Guangzhou 510055, China
  • Received:2015-06-15 Published:2015-12-01
  • Corresponding author: Xiqiang Liu
  • About author:
    Corresponding author: Liu Xiqiang, Email: , Tel: 020-83870405
引用本文:

梁珩, 周境, 陈小华, 庄泽航, 胡静, 刘习强. 头颈部混合型Rosai-Dorfman病1例及文献分析[J]. 中华口腔医学研究杂志(电子版), 2015, 09(06): 474-477.

Heng Liang, Jing Zhou, Xiaohua Chen, Zehang Zhuang, Jing Hu, Xiqiang Liu. Nodal and extranodal Rosai-Dorfman disease in head and neck: a case report with literature review[J]. Chinese Journal of Stomatological Research(Electronic Edition), 2015, 09(06): 474-477.

目的

探讨头颈部混合型Rosai-Dorfman病(RDD)的临床表现、组织病理学特征、诊断、治疗及预后。

方法

对1例混合型RDD行苏木精-伊红染色和免疫组织化学染色观察,对其进行随访并结合文献回顾分析。

结果

光镜下见大量淋巴细胞、浆细胞以及胞质苍白或呈嗜酸性淡染的特征性组织细胞,可见明显的淋巴吞噬现象(emperipolesis),免疫组化S-100和CD68染色阳性,CD1a阴性。本病的临床表现不典型,伴有颌面骨破坏吸收,容易误诊。予重组人粒细胞巨噬细胞刺激因子等治疗后病情控制。

结论

头颈部混合型RDD具有一定的组织病理学特征,但临床表现多样,诊断较困难。该病的治疗方法较多,效果不确定,应以保守治疗为主,密切随访。

Objective

To evaluate the pathological features, clinical manifestations, diagnosis, treatments and prognosis of Rosai-Dorfman disease (RDD) in head and neck.

Methods

HE staining and immunohistochemical analysis were performed in a case with both nodal and extranodal RDD in head and neck, follow-up data was collected and pertinent literatures were reviewed.

Results

Characteristic histiocytes with abundant pale or eosinophilic cytoplasm, and many lymphocytes and plasma cells were observed under light microscopy. A condition termed emperipolesis was found. Immunohistochemical staining was positive for both S-100 and CD68 but negative for CD1a. The clinical manifestation, along with destruction and resorption in maxillofacial bone, was atypical in this case and therefore apt to make a misdiagnosis. The patient shows partial remission on regular clinical and radiological follow-up followed immunotherapy.

Conclusions

Although RDD in head and neck has its specific pathological features, it presents differential clinical presentations and is hard to make an accurate diagnosis. Various treatments were used but none of them proved to be widely effective. Conservative treatment may be suitable for RDD in head and neck, and moreover, a long-term follow-up is indispensable.

图1 头颈部混合型RDD的PET-CT检查结果
图2 左颞下窝肿物和左颈淋巴结肿物病理学表现(苏木精-伊红 × 100)
图3 左颞下窝肿物(图3A~3C)和左颈淋巴结肿物(图3D~3F)免疫组化染色结果(SP法 × 20)
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