Korean Journal of Head & Neck Oncology (대한두경부종양학회지)

The Korean Society for Head and Neck Oncology (대한두경부종양학회)
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Clinical Characteristics of Subacute Necrotizing Lymphadenitis

아급성 괴사성 림프절염의 임상적 고찰

  • Park Chan-Hum (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hallym University) ;
  • Kim Hee-Dong (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hallym University) ;
  • Park Jun-Young (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hallym University) ;
  • Jo Hyeong-Ju (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hallym University) ;
  • Jun Jin-Hyoung (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hallym University) ;
  • Park Youn-Kyu (Department of General Surgery, College of Medicine, Hallym University) ;
  • Rho Young-Soo (Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Hallym University)
  • 박찬흠 (한림대학교 의과대학 이비인후-두경부외과학교실) ;
  • 김희동 (한림대학교 의과대학 이비인후-두경부외과학교실) ;
  • 박준영 (한림대학교 의과대학 이비인후-두경부외과학교실) ;
  • 조형주 (한림대학교 의과대학 이비인후-두경부외과학교실) ;
  • 전진형 (한림대학교 의과대학 이비인후-두경부외과학교실) ;
  • 박윤규 (한림대학교 의과대학 일반외과학교실) ;
  • 노영수 (한림대학교 의과대학 이비인후-두경부외과학교실)
  • Published : 1999.11.01
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Abstract

Background and Objectives: Subacute necrotizing lymphadenitis or Kikuchi's disease has now become recognized in many parts of the world as a well-defined clinicopathologic entity. It typically affects cervical lymph nodes of young women, and subsides spontaneously within a few months without recurrences. The purpose of this study is to report the clinicopathologic finding, radiologic finding and many laboratory tests to elaborate the criteria that are useful in distinguishing this entity from inflammatory disease, granulomatous disease, lymphoma, malignant disease. Material and Methods: Authors evaluated 22 patients, who were diagnosed as subacute necrotizing lymphadenitis on excisional biopsy or fine needle aspiration cytology with retrospective chart review. Results: The patient population consisted of 21 women and 1 men. The mean age was 25 years old(range 17 to 42 years). All patient had palpable neck mass and associated fever, headache, weight loss, otalgia, diarrhea, night sweating. and associated disorder is dermatitis, hepatitis B, SLE, Hashimoto's thyroiditis, albinism et al. The multiple bilateral involvement of cervical lymph node was 20 cases(91%) and multiple unilateral 18 cases(82%), multiple bilateral 2 cases(9%). Solitary involvement was 2 cases(9%), mean size of involved lymph node was 2.0cm. In laboratory tests, leukopenia 17 cases(72%), elevated ESR 12 cases(54%), elevated GOT, GPT 3 cases(13%). In CT finding, lymph nodes enhanced in homogeneous fashion, and there was no evidence of central necrosis. Conclusion: Subacute necrotizing lymphadenitis, Kikuchi's disease may be easily confused clinically, pathologically, radiologically with malignant lymphoma, inflammatory disease, granulomatous disease. We should consider open biopsy of lymph node in the patient which had unilateral multiple cervical lymph node and in laboratory tests, were leukopenia, elevated ESR, especially in young women. otherwise, result of fine needle aspiration biopsy is nonspecific, excisional biopsy is recommended in order to differentiate other disease.

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