Histiocytic necrotizing lymphadenitis (Kikuchi lymphadenitis) in an HIV-positive patient

Abstract

Histiocytic necrotizing lymphadenitis, or Kikuchi's lymphadenitis (KL), is an unusual form of lymphadenitis, generally with self-limited clinical course. KL has been reported in rare patients infected with the human immunodeficiency virus (HIV). Pathogenesis of the lesion is probably related to an impaired immune function. The purpose of the present article is to report on one case in which KL was diagnosed in an HIV-infected patient. Histomorphology and immunophenotype were similar to previous reports, but a focus of activated CD30+ macrophages was seen, what might be due to the immunological status of the patient. EBV was not detected on the sections using the in situ hybridization technique. Although rare, the occurrence of KL in HIV-infected subjects must be emphasized, because of the potential misdiagnosis of malignancy, especially in the presence of CD30+ cells.

The Enigmatic Kikuchi-Fujimoto Disease: A Case Report and Review

“…The awareness of this condition amongst clinicians and pathologists alike might help prevent misdiagnosis and inappropriate treatment [1]. This diagnosis should especially be considered in a young patient presenting with cervical lymphadenopathy with biopsy showing necrosis, fragmentation, and karyorrhexis [1, 3, 4, 6]. Recurrence is reported in about 4% of all cases of KFD.…”

Kikuchi’s disease: an important cause of cervical lymphadenopathy

“…17,18 Furthermore, other studies have described associations with infective disorders such as human T-lymphotropic virus (HTLV-1) and HIV. 19 Of note in our patient's case was the anti-tuberculous therapy she had received five years previously. It may be that this was the first manifestation of Kikuchi's, which went unrecognised.…”

Kikuchi–Fujimoto disease: a diagnostic dilemma

“…The clinical and histologic features of the disease suggest a viral etiology, with Epstein–Barr virus (EBV) being the virus most commonly detected . Other proposed inciting agents include human herpesvirus 6 (HHV‐6), HHV‐8, human immunodeficiency virus (HIV), human T lymphotrophic virus type 1, parvovirus B19, dengue virus, Yersinia enterocolitica , and species of Toxoplasma , Bartonella , and Brucella . Yet the causative roles of any of these pathogens remain controversial.…”