Histiocytic necrotizing lymphadenitis without granulocytic infiltration (Kikuchi's lymphadenitis). Morphological and immunohistochemical study of eight cases

Abstract

Eight examples of histiocytic necrotizing lymphadenitis without granulocytic infiltration (Kikuchi's lymphadenitis) are described. They occurred in young or middle‐aged women who usually complained of latero‐cervical lymphadenopathy. Serology revealed significant titres for Epstein‐Barr virus and Yersinia enterocolitica serogroup 9 in one of eight and one of six tested. All patients fully recovered within 2 months. On histological examination of the lymph nodes large foci of infiltration were observed in the cortex and/or paracortex: they consisted of variable numbers of small lymphocytes, immunoblasts, macrophages and so‐called plasmacytoid T‐cells; granulocytes were absent. Necrotic changes varied from single pyknotic cells to extensive areas of necrosis. Immunohistochemistry showed that within the lesion the number of macrophages was inversely proportional to the number of peripheral T‐lymphocytes and ‘plasmacytoid T‐cells'. The latter displayed a phenotype (CD4+, CD10+, CD45+) which, in the absence of macrophage‐associated antigens, seemed in keeping with their supposed lymphoid nature. In seven cases peripheral T‐lymphocytes predominantly expressed the cytotoxic/suppressor phenotype, while in one remaining case a mild predominance of the helper/inducer subset was observed. In the areas with less extensive tissue necrosis, numerous T‐immunoblasts expressed both markers of activation and the proliferation‐associated nuclear antigen Ki‐67. The results of the present study expand the spectrum of our knowledge and allow speculation as to the biology of this disease.

Kikuchi‐Fujimoto disease of 16 children in a single center of Korea

“…Usually KFD has a self‐limited course and resolves over a period of 1–4 months (11, 22). Therefore, most authors do not recommend treatment for KFD, and suggest only symptomatic and supportive therapy (22).…”

“…Usually KFD has a self‐limited course and resolves over a period of 1–4 months (11, 22). Therefore, most authors do not recommend treatment for KFD, and suggest only symptomatic and supportive therapy (22). Occasionally, reports show that KFD is associated with the hemophagocytic syndrome (5, 6), fatal myocarditis (8) and pulmonary hemorrhage (9).…”

“…This is because the latter is potentially harmful with a risk of injuring the submandibular glands, mar- ginal mandibular nerve and the facial vessels (16). Usually KFD has a self-limited course and resolves over a period of 1-4 months (11,22). Therefore, most authors do not recommend treatment for KFD, and suggest only symptomatic and supportive therapy (22).…”

Kikuchi hastalığı ve sistemik lupus eritematoz: olgu sunumu

“…İlginç olarak nekroza karşı nötrofilik veya eozinofilik reaksiyon yoktur. Bazı otörlere göre histiyositik proliferasyon (granülomatöz inflamasyon olmadan plazmasitoid monosit, küçük lenfositler, aktive T lenfositler ve plazma hücrelerinden oluşur) tek başına nekroza göre daha karakteristiktir [22][23][24] . Deri lezyonlarının histopatolojik incelemesi genellikle lökositoklastik vasküliti gösterir 25 .…”

Plasmacytoid Dendritic Cells Producing Interferon-α (IFN-α) and Inducing Mx1 Play an Important Role for CD4⁺Cells and CD8⁺ Cells in Necrotizing Lymphadenitis

“…This disease was originally reported by Japanese researchers in the early 1970s, [1][2][3] and has since been reported in other geographic regions. [4][5][6][7][8][9] The lymph node lesions of this disease have been extensively studied, [1][2][3][5][6][7][8][9][10][11][12] but to the best of our knowledge, there have been no reports in the literature describing in detail the change in distribution and morphology of plasmacytoid dendritic cells (PDCs), or the associations among CD4 + cells, CD8 + cells, PDCs, and peripheral blood monocytes and their time courses. Here, we investigated and discuss the role of PDCs in NEL by observing temporal changes in PDC morphology and the number of CD123 + (PDCs), Mx1 + , CD8 + , and CD4 + cells.…”