Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease): continuing diagnostic difficulties.

2.50
Hdl Handle:
http://hdl.handle.net/10541/91883
Title:
Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease): continuing diagnostic difficulties.
Authors:
Menasce, Lia P; Banerjee, Saumitra S; Edmondson, David; Harris, Martin
Abstract:
AIMS: To describe the clinicopathological and immunophenotypic features of 25 cases of Kikuchi-Fujimoto disease (K-F), which remains a poorly recognized entity and is still frequently confused with malignant lymphoma, and to discuss the main diagnostic problems experienced by the referring pathologist. METHODS AND RESULTS: Haematoxylin and eosin sections of 27 lymph node biopsies were re-examined. Immunostains for B-lymphocytes, T-lymphocytes and macrophages were performed. Clinical and follow-up data were obtained through a questionnaire to the referring pathologist or from the patients' notes where available. The suggested initial diagnoses are discussed. The lymph nodes showed a necrotizing process characterized by patchy or confluent areas of necrosis associated with karyorrhexis and absence or paucity of granulocytes. This was associated with a proliferation of large blastic cells consisting of a mixture of T-lymphocytes and histiocytes. Fragmentation of the biopsy was a frequent feature. The diagnosis of K-F was suggested by the referring pathologist in three cases only. The most common suggested diagnosis was that of a non-Hodgkin's lymphoma. CONCLUSION: This series documents continuing difficulties in the diagnosis of Kikuchi-Fujimoto disease in the UK and emphasizes that cases are still being mistakenly diagnosed as malignant lymphomas. The diagnosis of Kikuchi-Fujimoto disease merits active consideration in any nodal biopsy showing fragmentation, necrosis and karyorrhexis, especially in young women presenting with cervical lymphadenopathy.
Affiliation:
Department of Histopathology, Christie Hospital, Manchester, UK.
Citation:
Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease): continuing diagnostic difficulties. 1998, 33 (3):248-54 Histopathology
Journal:
Histopathology
Issue Date:
Sep-1998
URI:
http://hdl.handle.net/10541/91883
DOI:
10.1046/j.1365-2559.1998.00469.x
PubMed ID:
9777391
Type:
Article
Language:
en
ISSN:
0309-0167
Appears in Collections:
All Christie Publications

Full metadata record

DC FieldValue Language
dc.contributor.authorMenasce, Lia Pen
dc.contributor.authorBanerjee, Saumitra Sen
dc.contributor.authorEdmondson, Daviden
dc.contributor.authorHarris, Martinen
dc.date.accessioned2010-02-11T16:24:54Z-
dc.date.available2010-02-11T16:24:54Z-
dc.date.issued1998-09-
dc.identifier.citationHistiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease): continuing diagnostic difficulties. 1998, 33 (3):248-54 Histopathologyen
dc.identifier.issn0309-0167-
dc.identifier.pmid9777391-
dc.identifier.doi10.1046/j.1365-2559.1998.00469.x-
dc.identifier.urihttp://hdl.handle.net/10541/91883-
dc.description.abstractAIMS: To describe the clinicopathological and immunophenotypic features of 25 cases of Kikuchi-Fujimoto disease (K-F), which remains a poorly recognized entity and is still frequently confused with malignant lymphoma, and to discuss the main diagnostic problems experienced by the referring pathologist. METHODS AND RESULTS: Haematoxylin and eosin sections of 27 lymph node biopsies were re-examined. Immunostains for B-lymphocytes, T-lymphocytes and macrophages were performed. Clinical and follow-up data were obtained through a questionnaire to the referring pathologist or from the patients' notes where available. The suggested initial diagnoses are discussed. The lymph nodes showed a necrotizing process characterized by patchy or confluent areas of necrosis associated with karyorrhexis and absence or paucity of granulocytes. This was associated with a proliferation of large blastic cells consisting of a mixture of T-lymphocytes and histiocytes. Fragmentation of the biopsy was a frequent feature. The diagnosis of K-F was suggested by the referring pathologist in three cases only. The most common suggested diagnosis was that of a non-Hodgkin's lymphoma. CONCLUSION: This series documents continuing difficulties in the diagnosis of Kikuchi-Fujimoto disease in the UK and emphasizes that cases are still being mistakenly diagnosed as malignant lymphomas. The diagnosis of Kikuchi-Fujimoto disease merits active consideration in any nodal biopsy showing fragmentation, necrosis and karyorrhexis, especially in young women presenting with cervical lymphadenopathy.en
dc.language.isoenen
dc.subject.meshAdolescent-
dc.subject.meshAdult-
dc.subject.meshAntigens, CD-
dc.subject.meshAntigens, Differentiation, Myelomonocytic-
dc.subject.meshDiagnosis, Differential-
dc.subject.meshFemale-
dc.subject.meshHistiocytic Necrotizing Lymphadenitis-
dc.subject.meshHumans-
dc.subject.meshImmunohistochemistry-
dc.subject.meshLymphoma-
dc.subject.meshMale-
dc.subject.meshMiddle Aged-
dc.titleHistiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease): continuing diagnostic difficulties.en
dc.typeArticleen
dc.contributor.departmentDepartment of Histopathology, Christie Hospital, Manchester, UK.en
dc.identifier.journalHistopathologyen

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