{"title":"成人组织细胞坏死性淋巴结炎伴不明原因发热的临床分析:回顾性研究。","authors":"Nana Xie, Wencong Zhang, Fangbing Tian, Jia Chen, Wenyuan Zhang, Qiurong Ruan, Jianxin Song","doi":"10.1186/s13000-025-01695-2","DOIUrl":null,"url":null,"abstract":"<p><strong>Purpose: </strong>To comprehensively analyze the clinical data of histiocytic necrotizing lymphadenitis (HNL) in adults with fever of unknown origin (FUO), with the aim of enabling precise diagnosis.</p><p><strong>Patients and methods: </strong>A total of 15 HNL patients with FUO were enrolled. The analysis encompassed clinical manifestations, laboratory parameters <sup>18</sup>F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (<sup>18</sup>F-FDG PET/CT) imaging profiles, pathological features and therapeutic responses.</p><p><strong>Results: </strong>All patients presented with fever and lymphadenopathy (predominantly cervical). Laboratory findings included leukopenia (3.28 × 10⁹/L [2.40-4.97]), elevated LDH (306 U/L [187-524]), ESR (40 mm/h [30-51]), ferritin (457.1 ng/mL [206-1823.3]), and CRP (25 mg/L [6.1-34.8]) <sup>18</sup>F-FDG PET/CT detected metabolic lymph node abnormalities in 13 cases, primarily cervical and axillary. The pathological features were extensive coagulative necrosis of lymph nodes with reactive hyperplasia of histiocytes as well as positive or scattered positivity IHC CD3, CD4, CD8 and CD68. Corticosteroid achieved favorable responses, with only 2 cases progressing during follow-up.</p><p><strong>Conclusion: </strong>In clinical practice, patients with fever and lymphadenopathy should be given due attention. Pathological examination remains the gold standard for diagnosing HNL. Glucocorticoid therapy has proven effective, and the majority of patients with HNL exhibit a favorable prognosis.</p>","PeriodicalId":11237,"journal":{"name":"Diagnostic Pathology","volume":"20 1","pages":"92"},"PeriodicalIF":2.3000,"publicationDate":"2025-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335763/pdf/","citationCount":"0","resultStr":"{\"title\":\"Clinical analysis of histiocytic necrotizing lymphadenitis in adults with fever of unknown origin: a retrospective study.\",\"authors\":\"Nana Xie, Wencong Zhang, Fangbing Tian, Jia Chen, Wenyuan Zhang, Qiurong Ruan, Jianxin Song\",\"doi\":\"10.1186/s13000-025-01695-2\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Purpose: </strong>To comprehensively analyze the clinical data of histiocytic necrotizing lymphadenitis (HNL) in adults with fever of unknown origin (FUO), with the aim of enabling precise diagnosis.</p><p><strong>Patients and methods: </strong>A total of 15 HNL patients with FUO were enrolled. The analysis encompassed clinical manifestations, laboratory parameters <sup>18</sup>F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (<sup>18</sup>F-FDG PET/CT) imaging profiles, pathological features and therapeutic responses.</p><p><strong>Results: </strong>All patients presented with fever and lymphadenopathy (predominantly cervical). Laboratory findings included leukopenia (3.28 × 10⁹/L [2.40-4.97]), elevated LDH (306 U/L [187-524]), ESR (40 mm/h [30-51]), ferritin (457.1 ng/mL [206-1823.3]), and CRP (25 mg/L [6.1-34.8]) <sup>18</sup>F-FDG PET/CT detected metabolic lymph node abnormalities in 13 cases, primarily cervical and axillary. The pathological features were extensive coagulative necrosis of lymph nodes with reactive hyperplasia of histiocytes as well as positive or scattered positivity IHC CD3, CD4, CD8 and CD68. Corticosteroid achieved favorable responses, with only 2 cases progressing during follow-up.</p><p><strong>Conclusion: </strong>In clinical practice, patients with fever and lymphadenopathy should be given due attention. Pathological examination remains the gold standard for diagnosing HNL. Glucocorticoid therapy has proven effective, and the majority of patients with HNL exhibit a favorable prognosis.</p>\",\"PeriodicalId\":11237,\"journal\":{\"name\":\"Diagnostic Pathology\",\"volume\":\"20 1\",\"pages\":\"92\"},\"PeriodicalIF\":2.3000,\"publicationDate\":\"2025-08-09\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12335763/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Diagnostic Pathology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1186/s13000-025-01695-2\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"PATHOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Diagnostic Pathology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1186/s13000-025-01695-2","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"PATHOLOGY","Score":null,"Total":0}
Clinical analysis of histiocytic necrotizing lymphadenitis in adults with fever of unknown origin: a retrospective study.
Purpose: To comprehensively analyze the clinical data of histiocytic necrotizing lymphadenitis (HNL) in adults with fever of unknown origin (FUO), with the aim of enabling precise diagnosis.
Patients and methods: A total of 15 HNL patients with FUO were enrolled. The analysis encompassed clinical manifestations, laboratory parameters 18F-Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography (18F-FDG PET/CT) imaging profiles, pathological features and therapeutic responses.
Results: All patients presented with fever and lymphadenopathy (predominantly cervical). Laboratory findings included leukopenia (3.28 × 10⁹/L [2.40-4.97]), elevated LDH (306 U/L [187-524]), ESR (40 mm/h [30-51]), ferritin (457.1 ng/mL [206-1823.3]), and CRP (25 mg/L [6.1-34.8]) 18F-FDG PET/CT detected metabolic lymph node abnormalities in 13 cases, primarily cervical and axillary. The pathological features were extensive coagulative necrosis of lymph nodes with reactive hyperplasia of histiocytes as well as positive or scattered positivity IHC CD3, CD4, CD8 and CD68. Corticosteroid achieved favorable responses, with only 2 cases progressing during follow-up.
Conclusion: In clinical practice, patients with fever and lymphadenopathy should be given due attention. Pathological examination remains the gold standard for diagnosing HNL. Glucocorticoid therapy has proven effective, and the majority of patients with HNL exhibit a favorable prognosis.
期刊介绍:
Diagnostic Pathology is an open access, peer-reviewed, online journal that considers research in surgical and clinical pathology, immunology, and biology, with a special focus on cutting-edge approaches in diagnostic pathology and tissue-based therapy. The journal covers all aspects of surgical pathology, including classic diagnostic pathology, prognosis-related diagnosis (tumor stages, prognosis markers, such as MIB-percentage, hormone receptors, etc.), and therapy-related findings. The journal also focuses on the technological aspects of pathology, including molecular biology techniques, morphometry aspects (stereology, DNA analysis, syntactic structure analysis), communication aspects (telecommunication, virtual microscopy, virtual pathology institutions, etc.), and electronic education and quality assurance (for example interactive publication, on-line references with automated updating, etc.).