摘要：免疫球蛋白（immunoglobulin，Ig）G4相关性的硬化性疾病是一类纤维炎性病变，其特点是在多个解剖学部位形成瘤样病变和血清IgG4水平的升高。IgG4相关性淋巴结病定义为lgG4相关性硬化性疾病所致的淋巴结病变，该疾病可表现为5种组织学模式：（1）多中心Castleman病样；（2）反应性淋巴滤泡增生；（3）淋巴滤泡间伴免疫母细胞的浆细胞增多症；（4）进行性生发中心样转化和（5）炎性假瘤样。本研究中，我们报道了1例发生在37岁男性患者的IgG4相关性淋巴结病新的组织学形态，我们将其定义为“传染性单核细胞增多症样”。这种组织学形态的特点是大量成熟的浆细胞、浆细胞样细胞、大的嗜碱性转化淋巴细胞（免疫母细胞）、小-中等大小的淋巴细胞和组织细胞浸润破坏淋巴结结构。局灶可见血管周纤维化和核碎裂伴纤维蛋白原沉积。EB病毒（Epstein-Barr virus，EBV）编码的小RNA原位杂交显示散在1%~2%阳性小淋巴细胞。在激素治疗1个月后，血清中IeG4的初始值（>4400mg/dL）下降了50%。随访1年，患者病情稳定。该病例报道拓展了IgG4相关性淋巴结病的形态学谱系。
关键词：IgG4相关性硬化性疾病，IgG4相关性淋巴结病，传染性单核细胞增多症样，新的形态学谱系
AmJ Surg Pathol 2018；42：977-982
美国外科病理学杂志中文版2019年第1期全文No.4
唐立华 翻译 段亚琦 审校
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