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At least 19 recordsLinked to original sources
PubMed2003

Lupus lymphadenitis simulating Kikuchi's lymphadenitis in patients with systemic lupus erythematosus: a clinicopathological analysis of six cases and review of the literature.

Kikuchi's disease (KD) or Kikuchi's lymphadenitis (KL) is a self-limiting disease mostly affecting the cervical lymph nodes of young individuals. Whether the reported cases of KL associated with systemic lupus erythematosus (SLE) were genuine KL or lupus lymphadenitis (LL) simulating KL in SLE patients is not clear. We analyzed six cases of KD-like lymphadenitis occurring in SLE patients and 12 reported cases to clarify the relationship between KL and SLE. We found that not all cases occurred simultaneously with SLE. Eight cases occurred either before or after SLE. These cases might have true KL independent of SLE with the exception of two cases that occurred after SLE, but the patients still had lupus activity. The 10 cases that coexisted with SLE most likely had LL rather than KL. This was supported by the immunohistochemical finding of sparse cytotoxic T cells in those lymph nodes in contrast to abundant cytotoxic T cells usually seen in a typical KL. We conclude that KL is not related to SLE, and KD-like lymphadenitis coexisting with SLE should be regarded as LL. Pathologists should be aware of the possibility that LL can mimic KL in patients with SLE, especially necrotizing-type KL.

Adolescent↗
PubMed1983

Histiocytic necrotizing lymphadenitis. An ultrastructural study in comparison with other types of lymphadenitis.

The lymph nodes from 10 cases of histiocytic necrotizing lymphadenitis (HNL), 3 cases of necrotizing lymphadenitis with follicular hyperplasia (NLFH), and 11 cases of various types of lymphadenitis (abscess-forming, tuberculous, Piringer-type, "viral", and nonspecific lymphadenitides) were comparatively studied. The NLFH, clinically representing a milder form of collagen disease, showed necrotizing lesions similar to those of HNL but with follicular hyperplasia, more plasma cells, and scattered neutrophils; the latter features closely resemble those of some lymph nodes in systemic lupus erythematosus (SLE). Ultrastructurally, HNL and NLFH both showed coagulative necroses of individual lymphocytes, the macrophages with large cellular debris, prominent immunoblasts, and cytoplasmic inclusions such as frequent tubuloreticular structures (TRS) and "intracytoplasmic rodlets" (ICR). The necrotic modality in abscess-forming and tuberculous lymphadenitides was different and the macrophages contained smaller debris. The immunoblasts were less prominent in "viral" lymphadenitis and much less in the others. While TRS were present in may cases of other lymphadenitides as well, they were positive in a much smaller number of cells only; the ICR were found exclusively in HNL and NLFH. These findings suggest a relationship between HNL and NLFH; they may form a spectrum of hyperimmune reaction that includes SLE as an extreme manifestation.

Adolescent↗
PubMed1993

[Cervical lymphadenitis due to Mycobacterium malmoense in a child: case report and differential diagnosis of cervical lymphadenitis and lymphadenopathies].

Cervical lymphadenitis and lymphadenopathy are common in children and may be caused by local or systemic infection. There are a large number of possible etiologies. We report the case of a five-year-old boy with unilateral cervical lymphadenitis who was in good health and showed neither clinical nor laboratory signs of systemic infection. Despite repetitive empirical antimicrobial treatment, the lymph nodes increased in size. After surgical excision Mycobacterium malmoense grew from the lymph node culture. Based on a literature search (Embase and Medline 1980-1992), the most frequent infectious etiologies of pediatric cervical lymphadenitis and lymphadenopathies are summarized. Nontuberculous mycobacterial lymphadenitis is most frequent in children between one and five years of age, and is more common in girls than boys. The treatment of choice is surgical excision. In immunocompetent children treatment with antimycobacterial drugs is not needed even if relapse occurs.

Child, Preschool↗
PubMed1993

Human herpesvirus-6 genomes in histiocytic necrotizing lymphadenitis (Kikuchi's disease) and other forms of lymphadenitis.

The cervical lymph nodes of 27 patients with histiocytic necrotizing lymphadenitis (HNL) were examined, as were those of 9 patients with tuberculous lymphadenitis (Tb), 10 with reactive paracortical hyperplasia (RPH), and 10 with nonspecific lymphadenitis (NSL). Southern blot analysis, the polymerase chain reaction (PCR), and in situ hybridization were use to locate the human herpesvirus-6 (HHV-6) genome. Southern blot analysis showed that all cases were negative for HHV-6 genomes, although all but one HNL case expressed HHV-6 genome using PCR. On in situ hybridization all 10 HNL cases, 6 of the 10 RPH cases, 6 of the 10 NSL cases, and 2 of the 9 Tb cases showed HHV-6 DNA. These results indicate that the presence of HHV-6 genome is not specifically related to HNL, and that this virus could hibernate in a latent form in the cervical lymph nodes. In addition, we examined three different primers (A, B, and C) for PCR amplification of HHV-6 genomes.

Adolescent↗
PubMedDate not supplied

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

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.

Adult↗
PubMed1987

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

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.

Adolescent↗
PubMed2000

Kikuchi's lymphadenitis (necrotizing lymphadenitis) and systemic lupus erythematosus: a case report.

A 26-year-old Indian lady was admitted for lower abdominal pain, diarrhoea, vomiting, fever and cough. The initial diagnosis was that of peritonitis secondary to ruptured or perforated viscus with lobar pneumonia. On laparotomy, she was found to have necrotizing or Kikuchi's lymphadenitis of the abdominal lymph nodes. The initial two antinuclear antibody (ANA) results came back negative. She was diagnosed to have systemic lupus erythematosus (SLE) when the third sample for ANA came back positive and the double-stranded DNA (dsDNA) antibody test was homogenously positive. This case illustrates a need to be aware that necrotizing lymphadenitis can precede the onset of systemic lupus erythematosus.

Abdomen↗
PubMedDate not supplied

Prevalence of caseous lymphadenitis and usage of caseous lymphadenitis vaccines in sheep flocks.

OBJECTIVE: To estimate the prevalence of caseous lymphadenitis (CLA), determine the current usage of vaccines against CLA and to measure the effectiveness of these vaccines on sheep farms. DESIGN AND POPULATION: A survey was undertaken on 223 sheep flocks in New South Wales, Victoria and Western Australia. METHOD: The prevalence of CLA was measured by conventional inspection techniques at abattoirs in lines of sheep that could be traced back to a farm. Managers of the flocks were sent a questionnaire about their vaccine practices, management practices and knowledge of CLA. RESULTS: The average prevalence of CLA in adult sheep in these flocks was 26% and varied from 20% in Western Australia to 29% in New South Wales. About 43% of sheep producers used CLA vaccines; only 12% used them as recommended. Awareness of CLA was highest in Western Australia. More producers would use CLA vaccine if they knew the prevalence of CLA in their flock and producers obtained most information about CLA from vaccine resellers. CONCLUSIONS: Only 10 to 15% of producers are currently achieving effective CLA control through the use of recommended CLA vaccination programs. In Western Australian flocks more than 25% of effectively vaccinated ewes will be sent to abattoirs in the 2 to 3 years after this study. However, large decreases in the prevalence of CLA can be achieved by about 70% of producers by either making adjustments to their vaccination programs or buying a vaccine with a CLA component. Two or three key facts on effective CLA vaccination could be made available at the point of sale of vaccines and from abattoirs that reported the prevalence of CLA to farmers.

Animals↗
PubMed1996

Necrotizing lymphadenitis associated with systemic lupus erythematosus.

OBJECTIVE: Systemic lupus erythematosus (SLE) may have protean manifestations, including necrotizing lymphadenitis. After describing an illustrative case, we discuss the incidence, clinical features, and pathologic findings of SLE-associated necrotizing lymphadenitis. METHODS: A case of SLE associated with necrotizing lymphadenitis is reported. The patient's clinical presentation, course, and response to therapy is detailed. The literature on lupus lymphadenitis is reviewed. RESULTS: A young man who presented with a febrile illness characterized by multifocal necrotizing lymphadenitis is described. Glomerulonephritis, meningo-encephalitis, pericarditis, and hemolytic anemia evolved. The diagnosis of SLE was based on the clinical features, positive antinuclear antibody (ANA), and characteristic renal biopsy. High dose corticosteroids and cyclophosphamide induced a complete remission. In recent series from the literature the prevalence of lymphadenopathy was 12% to 59% of patients with SLE. The most common nodal groups involved were cervical (43%), mesenteric (21%), axillary (18%), and inguinal (17%). Lymph node pathology was characterized by paracortical foci of necrosis and infiltration by histiocytes, lymphocytes, plasma cells, and immunoblasts. The hematoxylin body, an amorphic aggregate of basophilic material, was pathognomonic of lupus lymphadenitis. The necrotizing lymphadenitis of SLE is pathologically similar to Kikuchi-Fujumoto disease (KFD), a distinctive, self-limited form of necrotizing lymphadenitis. The pathologic and clinical literature support a close link between SLE and KFD. CONCLUSIONS: SLE can be complicated by necrotizing lymphadenitis, with distinctive pathologic features. Lupus lymphadenitis and KFD share some common clinical and pathologic features, supporting a relationship between the disorders.

Adult↗
PubMed1999

Mycobacterial cervical lymphadenitis: the histological features of non-tuberculous mycobacterial infection.

AIMS: The distinction between nontuberculous mycobacterial (NTM) lymphadenitis and other causes of cervical lymphadenitis is critical, as different entities call for different treatments. Despite modern diagnostic techniques for NTM infections their prompt and accurate diagnosis is still difficult. We assessed the value of different histological features in diagnosing clinically suggestive NTM cervical lymphadenitis in cases of granulomatous cervical lymphadenitis. METHODS AND RESULTS: A retrospective study of 30 patients with a clinical diagnosis of NTM cervical lymphadenitis was carried out. The patients were divided into three subgroups and several histological parameters were examined in each subgroup. A comparison was made with cases of proven tuberculous lymphadenitis. Four histological features (presence of microabscesses, ill-defined granulomas, noncaseating granulomas and a small number of giant cells) were found with significant statistical difference when comparison was made between the NTM group and the tuberculosis group. CONCLUSIONS: A rapid and accurate diagnostic procedure for NTM lymphadenitis is not yet available. Therefore, in the presence of a suggestive clinical picture for NTM lymphadenitis, we propose four histological features which support this diagnosis, thus allowing prompt therapeutic intervention.

Adult↗
PubMed2002

Tuberculous and nontuberculous cervical lymphadenitis: a clinical review.

OBJECTIVES: The aim of the present study was to identify differences in clinical characteristics between patients with tuberculous cervical lymphadenitis and those with nontuberculous cervical lymphadenitis and to determine the diagnostic accuracy of fine needle aspiration (FNA) cytology. STUDY DESIGN AND SETTING: Seventy-two patients with inflammatory cervical lymphadenitis were studied retrospectively. They were divided into 2 groups: group 1 consisted of those with tuberculous lymphadenitis and group 2 consisted of those with non-tuberculous lymphadenitis. The demographic characteristics, clinical parameters, and hematological and cytological results of the 2 groups were compared. RESULTS: Other than there being a significantly higher proportion of foreign-born patients in group 1, there were no differences in clinical characteristics between the 2 groups. The sensitivity and specificity of FNA cytology in the diagnosis of tuberculous lymphadenitis were 88% and 96%, respectively. CONCLUSION: It is difficult to clinically differentiate tuberculous from nontuberculous lymphadenitis. FNA cytology is useful in the diagnosis of tuberculous lymphadenitis. SIGNIFICANCE: In regions where tuberculosis is endemic, treatment can be instituted without the need for excisional biopsy if the FNA results show characteristic caseating granuloma.

Adolescent↗
PubMed2005

Lymphadenitis caused by non-tuberculous mycobacteria in a university hospital in Taiwan: predominance of rapidly growing mycobacteria and high recurrence rate.

BACKGROUND AND PURPOSE: Lymphadenitis is the most common manifestation of infection due to non-tuberculous mycobacteria (NTM) in otherwise healthy children. This disease is rare in adults and its geographic variations in etiology and clinical manifestations remain unclear. The aim of this study was to describe the etiology, clinical presentation, treatment, and outcome of NTM lymphadenitis. METHODS: Medical records of patients with culture-proven NTM lymphadenitis treated at a university hospital in Taiwan from January 1997 through December 2004 were retrospectively reviewed. RESULTS: In total, 12 patients with NTM lymphadenitis were identified, including 6 males and 7 adults (> or = 16 years). The majority (83%) of patients presented with an enlarged palpable mass and 9 (75%) had preceding constitutional symptoms. The most common site of lymphadenitis was the cervical area (83%) and 8 patients (75%) had multiple lymph node involvement. Rapidly growing mycobacteria (RGM) accounted for 75% of the etiology of NTM lymphadenitis, followed by Mycobacterium avium complex (MAC) [2 patients]. A high recurrence rate (42%) after primary treatment was noted among those patients who received clarithromycin-containing regimens for a median of 6 months. CONCLUSIONS: This study found that both previously healthy children and adults were susceptible to NTM lymphadenitis. RGM was the most common etiology rather than MAC among NTM species causing lymphadenitis. Inadequate surgical excision of the diseased lymph nodes and insufficient coverage of antimycobacterial therapy both contributed to the high recurrence rate.

Adolescent↗