Histiocytic necrotizing lymphadenitis without granulocytic infiltration

Abstract

Twenty-seven cases of an unusual necrotizing lymphadenitis previously described only in Japan are reported as occurring in West Germany (23 cases), Iran (1 case), Italy (1 case), Korea (1 case) and Spain (1 case). The lesion frequently develops in the cervical lymph nodes of young women. It is characterized by infiltration of the cortex and/or paracortex by large collections of proliferating histiocytes and is devoid of granulocytes. Complete or, more often, incomplete necrosis of lymphoid tissue is seen in all cases. In cases with incomplete necrosis, the histiocytes are interspersed with pyknotic cells and nuclear debris. Based on the histological findings, the term "histiocytic necrotizing lymphadenitis without granulocytic infiltration" is proposed. Lesions to be considered in a differential diagnosis are malignant histiocytic neoplasms and necrotizing lymphadenitis with granulocytic infiltration, which is seen in lupus erythematosus and bacterial infections. The aetiology of histiocytic necrotizing lymphadenitis without granulocytic infiltration is still unclear. Some clinical and histological features indicate the possibility of an underlying viral infection.

Benign lymphadenopathies

“…[23][24][25][26] It most commonly affects young Asian women, although it may occur in both sexes and in all age groups and ethnicities. Patients most often present with isolated cervical lymphadenopathy, which may be tender, and of several months duration.…”

Kikuchi Disease Associated with Overlap Syndrome Responding to Steroids

“…It is characterized by lymphadenopathy most commonly affecting the cervical lymph nodes; however, the lymphadenopathy may be generalized. 1 The disease was described worldwide including Saudi Arabia.…”

“…9 They may be painful and tender. 1,2 Fever is present in 30% to 50%. 1,9 A weight loss, night sweats, mild splenomegaly and abdominal lymphadenopathy are rare manifestations of the disease.…”

“…1,2 Fever is present in 30% to 50%. 1,9 A weight loss, night sweats, mild splenomegaly and abdominal lymphadenopathy are rare manifestations of the disease. 9,10 Anemia may be due to decreased intake.…”

Kikuchi Disease Presenting as Anemia

“…7 Cases presenting with pyrexia of unknown origin (PUO), as well as with splenomegaly 9 were reported. We are reporting a case of Kikuchi disease presenting with anemia.…”