Type II immunoblastic lymphadenopathy
Introduction
Introduction to type II immunoblastic lymphadenopathy The clinical features of this disease are similar to the aforementioned type I immunoblastic lymphadenopathy, but the prognosis is poor. It can be regarded as a marginal disease of lymphoid tumors, similar to immunoproliferative disorders. According to pathological and immunological features, it has gradually To clarify that this disease is different from the aforementioned type I immunoblastic lymphadenopathy, it can also be called T cell lymphoma-like immunoblastic lymphadenopathy. basic knowledge The proportion of illness: 0.002% Susceptible people: no special people Mode of infection: non-infectious Complications: splenomegaly
Cause
Type II immunoblastic lymphadenopathy
(1) Causes of the disease
The cause of this disease is unknown. Some people think that this disease is related to viral infection. Some patients have detected the DNA of Epstein-Barr virus in the lymph nodes (PCR method). Some people think that due to the infection of the subtype of artificial cell lymphoma virus, the immune function of the body is abnormal. Lead to the disease.
(two) pathogenesis
1. The pathogenesis of this disease is still unclear. The patient's T cell subset analysis found that the disease is T cell lesions, and some cases mainly include inhibitory T cells (TS), and some with helper T cells (TH). Mainly, both of them increase. These T cells may produce B cell stimulating factors, promote B cell proliferation, and secrete immunoglobulins. The main proliferating cells of type II immunoblastic lymphadenopathy are diverse, including Immune mother cells and leukocytic cells, the former nucleolus is large and the nucleus is naive, and the cell body is strongly basophilic; the latter cell body is large and clear, the size is different but its maturity is the same, and its appearance is similar to that of immature plasma cells, which is histologically Malignant proliferation.
2. Pathology: typical pathological changes in addition to the characteristics of type I immunoblastic lymphadenopathy, there are tumor-proliferating of immunoblasts or leukocytic cells, cytological diagnosis in addition to granulomatous changes (plasma cells increase, tissue cells In addition to the increase in eosinophils, there are tumor immunonuclear cells and large and pale lymphoid cells. In the lymph nodes at the beginning of the disease, when the tumor cells proliferate less, it is easy to be diagnosed as reactive lymph node hyperplasia.
Prevention
Type II immunoblastic lymphadenopathy prevention
1. Early detection and early diagnosis and treatment, establish confidence in the fight against disease, adhere to treatment, and maintain optimism.
2. Prevention of infection, prevention of streptococcal infection is an important part of autoimmune rheumatic diseases and co-morbidity.
Complication
Type II immunoblastic lymphadenopathy complications Complications
Can be complicated by systemic lymphadenopathy, mostly accompanied by hepatosplenomegaly.
Symptom
Type II immunoblastic lymphadenopathy symptoms common symptoms hepatosplenomegaly lymph node swelling fever
May have fever, rash (drug rash), systemic lymphadenopathy, more with hepatosplenomegaly, lymph node enlargement in the early stage of the disease, often with temporary reduction after treatment with antibiotics or glucocorticoids.
Examine
Examination of type II immunoblastic lymphadenopathy
1. Blood and bone marrow images: Plasmacytoid mononuclear cells can be seen, but their incidence is generally low.
2. Biochemical examination: Polyclonal hypergammaglobulinemia can be seen, and the degree of elevation is parallel to the deterioration of symptoms.
Immunological examination: Proliferating immunoblasts and pallid cells have T cell markers, and more than half of patients have positive Ia-like antigens, no TAT activity, and some patients have Toxoplasma antibodies, measles virus antibodies, herpes simplex virus antibodies, etc. Elevated, and some patients may be accompanied by Coomb-positive hemolytic anemia.
Diagnosis
Diagnosis and diagnosis of type II immunoblastic lymphadenopathy
The disease is pathologically diagnosed as Hodgkin's disease or Lenner's lymphoma, but the diagnosis can be further confirmed by the above clinical features and determination of tumor cells and analysis of membrane traits.
To be differentiated from Hodgkin's disease or Lenner's lymphoma.
