[何杰金氏病——病因学和临床表现的当前问题]。

Strahlentherapie Pub Date : 1985-04-01
H D Waller
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摘要

自1832年霍奇金首次描述淋巴肉芽肿病以来,其病因学和病理生理学的概念发生了本质上的变化。在以前的文献中,这种疾病最初被认为是一种具有假白血病病程的淋巴系统结核,然后被认为是一种炎症性疾病,然后被认为是介于癌症和结核病之间的中间状态,最后被认为是一种慢性自身免疫过程,伴随着肿瘤和正常淋巴样细胞之间的相互作用。今天的症状被定义为淋巴网状系统的恶性疾病,开始于单个淋巴结,然后扩散到其他淋巴结,并通过血液繁殖扩散到实质器官。肉芽肿组织的组织学检查显示霍奇金细胞有一个核,斯特恩伯格-里德巨细胞有几个核。霍奇金细胞的起源尚不清楚,但是,单克隆抗体的研究提示,这些前体细胞具有粒细胞生成细胞的一些特征,但也具有特异性单克隆抗体识别的抗原。免疫系统表现出一些变化,尤其是在细胞免疫方面。这种疾病的演变可能与细胞免疫系统的问题有关。治疗方式取决于根据安娜堡会议分类的阶段。诊断应在合理的方面建立,并借助于最新的图像生成方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
[Hodgkin's disease--current problems in etiology and clinical picture].

The conception of etiology and pathophysiology of lymphogranulomatosis has essentially changed since the first description made by Hodgkin in 1832. In former communications, this disease was initially regarded as a tuberculosis of the lymphatic system with a pseudoleukemic course, then as an inflammatory disease, then as an intermediate state between cancer and tuberculosis, and finally as a chronic autoimmune process accompanied by interactions between neoplastic and normal lymphoid cells. Today the symptomatology is defined as a malignant disease of the lymphoreticular system beginning in a single lymph node, then expanding to other lymph nodes and spreading out by hematogenic propagation into the parenchymatous organs. The histologic examination of granulomatous tissue shows Hodgkin cells with one nucleus and Sternberg-Reed giant cells with several nuclei. The origin of Hodgkin cells is not yet clear, however, there are some hints resulting from investigations with monoclonal antibodies that the precursor cells possess some characteristics of granulopoietic cells, but also of antigens which are recognized by specific monoclonal antibodies. The immune system shows some modifications, above all with regard to the cellular immunity. The evolution of the disease is probably determined by some correlations with troubles of the cellular immune system. The treatment modalities depend on the stage which is classified according to the Ann Arbor Conference. The diagnosis should be established under rational aspects and with the aid of the most recent image-producing methods.

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