超声诊断木村病的临床价值(1)
摘要：目的 探讨超声诊断木村病的临床价值。方法 回顾性分析2009年7月～2017年1月经我院穿刺活检或手术病理证实的22例木村病患者临床资料，分析其临床表现、超声声像图特点及病理学表现。结果 22例患者中，17例为男性。35个病灶中，29个位于头颈部，4个位于上臂，1个位于腹股沟，1个位于腋窝。16例多发，6例单发。17例表现为低回声，3例为稍高回声，2例为混合回声。7例患者内病灶血流较丰富为Ⅱ～Ⅲ级，4例血流为Ⅲ，3例血流为Ⅱ，6例血流为Ⅰ级，1例血流为0级，1例血流为Ⅰ～Ⅱ级。血常规检查中，6例患者白细胞增高， 16例患者在正常范围。17例患者嗜酸性粒细胞及嗜酸性粒细胞绝对值计数增加。10例行血清IgE检查，血清IgE升高9例。各部位病灶主体及淋巴结镜下病变呈分叶状，可见增生的淋巴组织，淋巴组织内可见淋巴滤泡结构，生发中心及套区结构清楚，滤泡间区淋巴细胞间散在分布大量嗜酸性粒细胞，小血管增生明显，但未见上皮样血管内皮增生，嗜酸性粒细胞局部呈嗜酸性脓肿样改变。结论 根据木村病的超声特有表现，多发于男性，病程较长，超声于头颈部皮下软组织内发现淋巴结肿大或边界不清的“斑块状”团块，血供较丰富，实验室检查外周血嗜酸性粒细胞增多，血清IgE升高，结合病史和实验室检查有助于木村病的提示诊断和鉴别诊断，并利用超声检查重复性好等优势随时观察病情变化及临床治疗效果。
关键词：超声检查;木村病;嗜酸性粒细胞百分比
中图分类号：R445.1;R597 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.12.056
文章編号：1006-1959(2019)12-0165-04
Abstract：Objective To investigate the clinical value of ultrasound in the diagnosis of Kimura's disease.Methods The clinical data of 22 patients with Kimura's disease confirmed by biopsy or pathology in our hospital from July 2009 to January 2017 were retrospectively analyzed. The clinical manifestations， sonographic features and pathological findings were analyzed. Results Of the 22 patients， 17 were male. Of the 35 lesions， 29 were located in the head and neck， 4 in the upper arm， 1 in the groin， and 1 in the armpit. 16 cases were multiple and 6 cases were single. 17 cases showed low echo， 3 cases had slightly higher echoes， and 2 cases had mixed echoes. The blood flow of the lesions in the 7 patients was grade Ⅱ～Ⅲ， the blood flow was Ⅲ in 4 cases， the blood flow was II in 3 cases， the blood flow was grade I in 6 cases， the blood flow was grade 0 in 1 case， and the blood flow was 1 in 1 case. Ⅰ～Ⅱ level. In routine blood tests， 6 patients had elevated white blood cells and 16 patients were in the normal range. The absolute counts of eosinophils and eosinophils increased in 17 patients. 10 patients underwent serum IgE and serum IgE increased in 9 patients. The lesions in each part and the lesions in the lymph nodes were lobulated， and the proliferating lymphoid tissues were visible. Lymphoid follicular structures were observed in the lymphoid tissues. The germinal center and the cuff structure were clear， and a large number of eosinophils were scattered between the lymphocytes in the interfollicular region. Cells， small blood vessels proliferated significantly， but no epithelioid vascular endothelium hyperplasia， eosinophils showed eosinophilic abscess-like changes. Conclusion According to the unique manifestations of ultrasound in Kimura's disease， it occurs mostly in men， and the course of disease is longer. Ultrasound is found in the subcutaneous soft tissue of the head and neck. The lymph nodes are swollen or the borders are unclear. The plaque-like mass is rich in blood supply. Laboratory examination peripheral blood eosinophilia， elevated serum IgE， combined with medical history and laboratory tests to help the diagnosis and differential diagnosis of Kimura's disease， and the use of ultrasound to check the reproducibility and other advantages at any time to observe changes in the condition and clinical treatment., http://www.100md.com(杨琴慧 李志东 陈力)
关键词：超声检查;木村病;嗜酸性粒细胞百分比
中图分类号：R445.1;R597 文献标识码：A DOI：10.3969/j.issn.1006-1959.2019.12.056
文章編号：1006-1959(2019)12-0165-04
Abstract：Objective To investigate the clinical value of ultrasound in the diagnosis of Kimura's disease.Methods The clinical data of 22 patients with Kimura's disease confirmed by biopsy or pathology in our hospital from July 2009 to January 2017 were retrospectively analyzed. The clinical manifestations， sonographic features and pathological findings were analyzed. Results Of the 22 patients， 17 were male. Of the 35 lesions， 29 were located in the head and neck， 4 in the upper arm， 1 in the groin， and 1 in the armpit. 16 cases were multiple and 6 cases were single. 17 cases showed low echo， 3 cases had slightly higher echoes， and 2 cases had mixed echoes. The blood flow of the lesions in the 7 patients was grade Ⅱ～Ⅲ， the blood flow was Ⅲ in 4 cases， the blood flow was II in 3 cases， the blood flow was grade I in 6 cases， the blood flow was grade 0 in 1 case， and the blood flow was 1 in 1 case. Ⅰ～Ⅱ level. In routine blood tests， 6 patients had elevated white blood cells and 16 patients were in the normal range. The absolute counts of eosinophils and eosinophils increased in 17 patients. 10 patients underwent serum IgE and serum IgE increased in 9 patients. The lesions in each part and the lesions in the lymph nodes were lobulated， and the proliferating lymphoid tissues were visible. Lymphoid follicular structures were observed in the lymphoid tissues. The germinal center and the cuff structure were clear， and a large number of eosinophils were scattered between the lymphocytes in the interfollicular region. Cells， small blood vessels proliferated significantly， but no epithelioid vascular endothelium hyperplasia， eosinophils showed eosinophilic abscess-like changes. Conclusion According to the unique manifestations of ultrasound in Kimura's disease， it occurs mostly in men， and the course of disease is longer. Ultrasound is found in the subcutaneous soft tissue of the head and neck. The lymph nodes are swollen or the borders are unclear. The plaque-like mass is rich in blood supply. Laboratory examination peripheral blood eosinophilia， elevated serum IgE， combined with medical history and laboratory tests to help the diagnosis and differential diagnosis of Kimura's disease， and the use of ultrasound to check the reproducibility and other advantages at any time to observe changes in the condition and clinical treatment., http://www.100md.com(杨琴慧 李志东 陈力)