作者：徐秀红，李波，马浩源，周毅，矫树生，程晓芳，陈立平，刘久志，智建霞，赵莉

单位：

1.050082河北省石家庄市，解放军联勤保障部队第九八〇医院神经内科 2.050000河北省石家庄市人民医院神经内三科 通信作者：李波，E-mail：leebo2021@163.com

Units：

1.Department of Neurology, 980 Hospital of PLA Joint Logistics Support Forces, Shijiazhuang 050082, China 2.Department of Neurology, Shijiazhuang People's Hospital, Shijiazhuang 050000, China Corresponding author: LI Bo, E-mail: leebo2021@163.com

关键词：

组织细胞坏死性淋巴结炎; 脑梗死; 误诊; 病例报告;

Keywords：

Histopathic necrotizing lymphadenitis; Cerebral infarction; Diagnostic errors; Case reports

CLC：

DOI：

10.12114/j.issn.1008-5971.2022.00.153

Funds：

摘要：

组织细胞坏死性淋巴结炎(HNL)为少见疾病,伴神经系统受损的HNL临床更为罕见。本文报道1例主因“发热11 d”收住院的中年男性患者,入院第3天出现神经系统症状,考虑为“急性脑梗死”,经颈部淋巴结穿刺活检病理检查及免疫组织化学染色检查确诊为HNL,给予糖皮质激素治疗后体温恢复正常。提示,对于发热、淋巴结肿大的患者,其出现神经系统受损时诊断脑梗死应谨慎,需考虑HNL可能,应尽早行淋巴结穿刺活检以明确诊断,且应用糖皮质激素等药物综合治疗是改善患者预后的关键。

Abstract：

【Abstract】　Histiocytic necrotizing lymphadenitis (HNL) is a rare disease, and HNL with nervous system damageis even rarer in clinical practice. In this report, a middle aged male patient hospitalized with fever for 11 days and developedneurological symptoms and signs on the third day and was diagnosed with "acute cerebral infarction". The patient was confirmedwith HNL by pathological. After treatment with glucocorticoids biopsy and immunohistochemical staining of cervical lymph, thepatient's temperature returned to normal. Even with nervous system damage, the diagnosis of acute cerebral infarction should bemade cautiously in patients with fever and lymphadenopathy and the possibility of HNL should be taken into account. Lymph nodebiopsy should be performed as soon as possible to confirm the diagnosis. The combined application of glucocorticoids and otherdrugs is the key to improve the prognosis of patients.

ReferenceList：