Histiocytic Necrotizing Lymphadenitis (Kikuchi's Disease): The Necrotic Appearance of the Lymph Node Cells Is Caused by Apoptosis

Ura, Hironobu; Yamada, Nobuo; Torii, Hideshi; Imakado, Sumihisa; Iozumi, Ken; Shimada, Shinji

doi:10.1111/j.1346-8138.1999.tb03494.x

Cited by 20 publications

(16 citation statements)

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“…The presence of fragmented nuclei suggests the involvement of apoptosis [20]. The Fas-Fas ligand system may play an important role in the occurrence of apoptosis in KFD, as evidenced by positive Fas reactivity in many lymph node cells in KFD [16,20]. The perforin pathway may also play a role in apoptosis in KFD [21].…”

Section: Discussionmentioning

confidence: 99%

Kikuchi‐Fujimoto Disease: A Case Report

Lee

Cheng

2003

The Kaohsiung J of Med Scie

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We describe a rare but typical case of Kikuchi-Fujimoto disease (KFD). Two subcutaneous nodules appeared suddenly on the right of the neck of a 15-year-old girl. Microscopy of a surgical specimen of the larger nodule showed necrotizing lymphadenitis. Prompt treatment with mepirizole resulted in the disappearance of the smaller nodule. No recurrence was noted during 6 months of follow-up. KFD is a rare, self-limiting, necrotizing histiocytic lymphadenitis that needs to be differentiated from malignant lymphoma. Any nodal biopsy showing fragmented nuclei, necrosis, and karyorrhexis without prominent neutrophils should alert the physician to consideration of KFD, especially in a young woman presenting with cervical lymphadenopathy.

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Section: Discussionmentioning

confidence: 99%

Kikuchi‐Fujimoto Disease: A Case Report

Lee

Cheng

2003

The Kaohsiung J of Med Scie

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“…If unilateral enlarged cervical nodes appear it is necessary to eliminate other causes in the differential diagnosis (infectious mononucleosis, toxoplasmosis, tuberculosis lymphadenitis, cat scratch disease, metastatic carcinoma) and, above all, it is important to eliminate high grade lymphoma and SLE in order not to overtreat the patients with aggressive therapy [7]. The numerous atypical monocytes and T-cell immunoblasts observed in KFD may lead to an erroneous diagnosis of lymphoma, particularly if early lesions are present and the necrosis is minimal.…”

Section: Discussionmentioning

confidence: 99%

“…According to the immunopathogenesis theory, KFD is associated with a hyperimmune reaction of T lymphocytes and histiocytes to a variety of antigens, with elevated apoptosis mediated via the Fas ligand and perforin [7][8][9]. Since apoptotic cells are T4 lymphocytes, they are considered as effectors and target cell at the same time, whereas histiocytes may act as enhancers of the process [10].…”

Section: Discussionmentioning

confidence: 99%

Necrotizing cervical lymphadenopathy: Kikuchi-Fujimoto disease in a young male

Glaser

Borin

Kavalar

et al. 2008

Wien Klin Wochenschr

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Kikuchi-Fujimoto disease (KFD) or histiocytic necrotizing lymphadenitis is a rare benign disease, more common in Japanese women, with only a few cases reported from other parts of the world. The pathogenesis is poorly understood. A 22-year-old man noticed a node growth a month before his admittance. At first he noticed one enlarged node in the left axilla, later also the nodes on his neck and in his right axilla. Before that he had felt shivery and reported night sweats. Physical examination revealed bilateral enlarged (up to 2 cm) painful but not inflamed lymph nodes on the neck and in both axillae. The patient was diagnosed with KFD on histological examination of the nodes and on the basis of typical changes. No medical treatment was prescribed and the patient has been without symptoms for the past two years. The clinical picture of KFD is nonspecific and variable. Most patients complain of enlarged cervical nodes (up to 2 cm) accompanied by various symptoms (fever, malaise, night sweats, weight loss). The enlarged nodes, which are mobile, rarely appear in other locations. The only way of proving whether the disease is present or not is by histological examination of the node, which may show the following changes typical for KFD: paracortical necrotic foci, surrounded by histiocytic aggregates, irregular rounded eosinophilic areas of different sizes in the paracortex and cortex with the presence of numerous histiocytes, lymphocytes, immunoblasts, plasmacytoid monocytes and eosinophilic granulated cellular debris. Histiocytes had mostly turned into foamy macrophages. It is typical not to find epithelioid cells and neutrophil granulocytes in the necrotic centers. In particular, the disease needs to be distinguished from high-grade lymphoma and SLE lymphadenitis. There is no specific medical treatment for KFD since the disease usually resolves spontaneously over four months. Disease recurrence or fatalities are unusual.

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“…We could not demonstrate any speci®c agent in the serologic work-up of our patient. Apoptosis is a prominent feature of the disease [18,19]. Takakuwa et al proposed that KFD should be called apoptotic lympadenitis [19].…”

Section: Discussionmentioning

confidence: 99%