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目的：研究以淋巴结首发的ＬＣＨ形态结构特征、免疫表型、临床表现及鉴别诊断。方法：应用ＨＥ染色和免疫组化ＡＢＣ法标记Ｏ１０和Ｓ－１００阳性以确定诊断。结果：１４例淋巴结ＬＣＨ有４种组合类型：（１）肾形及卵圆形细胞４例；（２）咖啡豆样细胞３例；（３）咖啡豆样及大圆形细胞５例；（４）大圆形细胞２例。结论：咖啡豆样细胞是ＬＣＨ的特征细胞，具有重要诊断价值，嗜酸性粒细胞是ＬＣＨ重要的组成成分之一。根据细胞形态、分化程度和不同组合，ＬＣＨ分为：①反应性，②交界性，③低度恶性，④高度恶性（肉瘤型）。
Objective: To study the morphological features, immunophenotypes, clinical manifestations and differential diagnosis of LCH with first lymph node. METHODS: HE staining and immunohistochemistry were used to label positive O10 and S-100 for diagnosis. RESULTS: There were 4 combinations of LCH in 14 cases: (1) kidney and oval cells in 4 cases; (2) coffee bean-like cells in 3 cases; (3) coffee bean-like and large round cells in 5 cases; 4) Large round cells in 2 cases. Conclusion: Coffee bean-like cells are characteristic cells of LCH and have important diagnostic value. Eosinophils are one of the most important components of LCH. According to cell morphology, differentiation and different combinations, LCH is divided into: 1 reactive, 2 borderline, 3 low malignant, 4 highly malignant (sarcoma type).