The Pathological Analysis Of Superficial Lymph Nodes In 1174 Patients With Fever--The Review Of Biopsy Data In 43 Years

Pathological diagnosis on lymph node is one of hot point. Lymph node biopsy is a main task in confirming the etiological factor for patients with fever, but is very difficult. It also affects the level of clinical diagnosis and treatment. This article provide a group of lymph node biopsy data in 1174 patients with fever during 43 years(1953～1995 year) which was derived from two medical university affiliated general hospitals (mainly Tianjin medical university general hospital ) in a big city in north China. No such report had been published. This group of data was impersonal for its long interval and large sample. It will have consult and practice value for both pathologist and clinical doctor (especially for physician).Objective:To analysis the data of 1174 Lymph node biopsy specimens during 43 years and to investigate the general pathological characteristic and some regarded problem of pathological diagnosis about basic diseases/lesions, which was expected to improve the level of pathological diagnosis. Material and Methods:Ⅰ. The paraffin embedded tissue –HE slices of 1174 Lymph node biopsy specimens of patients with fever were from the Department of Pathology, general hospital and the second hospital of Tianjin Medical University during the last 43 years (1953～1995). The HE slices of every case were reviewed with the help of supervisor. Ⅱ. The analysis of the reviewed pathological data (Ⅰ)The general analysis: The correlation on the sex, age, biopsy site and basic disease/lesion of 1174 patients with fever and lymph node biopsy.(Ⅱ)The analysis of special purpose: 1．454 cases that was diagnosed chronic lymphadenitis originally；2．24 cases that was diagnosed non-tuberculosis granuloma finally.3．65 cases that was diagnosed Kikuchi disease originally.4．347 cases that was diagnosed lymph node tuberculosis finally.5．40 cases that was diagnosed lymph node metastasis finally.6．87 cases that was diagnosed Hodgkin's lymphoma finally.7．67 cases that was diagnosed Non-Hodgkin's lymphoma finally.Ⅲ. Assist detection(Ⅰ)Special staining1. Ziehl-Neelsen acid fast staining that was used to diagnose tuberculosis2. Mucicarmine staining that was used to diagnose lymph node Cryptococcosi(Ⅱ)Immunohistochemistry was used to ① change the diagnosis of HL in 34 cases,② change benign lesion to NHL in 67 cases,③ differentiate between lymphoma and metastasis.(Ⅲ)The gene rearrangement of IgH and TCR was used to detect 67cases NHL that was diagnosed benign lesion originally.(Ⅳ)Flow cytometry was used to detect 67cases NHL that was diagnosed benign lesion originally. Ⅳ. Patients follow-up was used to detect 67cases NHL that was diagnosed benign lesion originally.Ⅴ. Statistical analysis:χ-square test and t test was used according to different data.Results:Ⅰ. The general pathological characteristic of 1174 patients with fever and lymph node biopsy(Ⅰ) The ratio of male and female was 1:0.86。(Ⅱ)The range of age was extensive that was 2～82 years old,mean age was 32.44, peaked at 21～30 years old, the incidence of adults was mainly analyzed. (Ⅲ)The constituent ratio in 4 groups affected superficial lymph nodes was sorted as follow:①cervical lymph node(49.15％)＞②inguinal lymph node (16.78％)＞③axillary lymph node(14.48％)＞④supraclavicular lymph nodes (11.75％). (Ⅳ)The category of basic disease／leison1．The constituent ratio was sorted:①reactive lesion of non-granuloma (41.74％)＞②non-neoplastic granuloma (30.15％)＞③lymphoma(21.55％)＞④metastasis(3.41％)＞⑤atypical hyperplasia (1.7％)＞⑥other malignant tumors(1.11％)。2．The total percentage of reactive lesion of non-granuloma , non-neoplastic granuloma and lymphoma was 93.35％,which was the main basic category,which occupies 4, 3, 2, folds respectively.3．The percentage of reactive lesion of non-granuloma in female was significantly higher than that of female(P<0.01)but the percentage of non-neoplastic granuloma in male was significantly lower than...