• Title/Summary/Keyword: Histiocytic Necrotizing Lymphadenitis

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Histiocytic Necrotizing Lymphadenitis (Kikuchi -Fujimoto Disease) - A Clinicopathologic Study of 3 Cases - (조직구 괴사성 림프절염 3례)

  • Chang, Yu-Chol;Hwang, Chan-Seung;Hong, Young-Ho;Kim, Hoon
    • Korean Journal of Bronchoesophagology
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    • v.4 no.1
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    • pp.127-131
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    • 1998
  • Histiocytic necrotizing lymphadenitis(NHL), or Kikuchi-Fujimoto disease, is of unknown origin that causes persistently enlarged cervical lymph nodes unresponsive to antibiotic therapy, usually in young women. Symptoms of NHL include tender cervical adenopathy, fever, weight loss, and night sweats. Laboratory studies usually reveal leukopenia and increased erythrocyte sedimentation rate. Lymph node biopsy reveals areas with frank cell necrosis, karyorrhexis, and absence of plasma cells. NHL follows a benign course, but shoud be differentiated from other diseases such as inflammatory, granulmomatous and malignant lymphadenopathies. We describe . three cases of NHL with a review of the literature.

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A Case of Aseptic Meningitis and Unilateral Vestibulopathy Associated with Histiocytic Necrotizing Lymphadenitis(Kikuchi's disease) (조직구괴사림프절염(Kikuchi병)과 동반된 무균뇌수막염과 한쪽 전정신경병증)

  • Kim, Kyung Jib;Do, Jin Kuk;Lee, Dong Kuck
    • Annals of Clinical Neurophysiology
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    • v.9 no.2
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    • pp.93-96
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    • 2007
  • A 34-year-old man presented with a severe headache, fever, and cervical lymphadenopathy followed by generalized tonic-clonic seizure. Evaluations showed splenomegaly, elevated liver enzymes, and 380 white blood $cells/mm^3$ in the cerebrospinal fluid. Two weeks after admission, he developed sudden vertigo. Examination revealed spontaneous horizontal-torsional nystagmus to the right and bithermal caloric tests documented left canal paresis. A cervical lymph node biopsy disclosed subacute necrotizing lymphadenitis. We report a case of aseptic meningitis and unilateral vestibulopathy associated with histiocytic necrotizing lymphadenitis (Kikuchi's disease).

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Detection of HHV6 and EBV in histiocytic necrotizing lymphadenitis (Histiocytic necrotizing lymphadenitis에서 HHV6과 EBV의 검출)

  • Park, Kyung Hee;Park, Sung Shik;Kim, Ji Yeon;Park, Su Eun
    • Clinical and Experimental Pediatrics
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    • v.51 no.9
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    • pp.987-991
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    • 2008
  • Purpose : Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis (HNL), is a self-limited disease characterized by cervical lymphadenopathy and fever. The etiology of KFD remains unknown; however, the self-limiting nature of HNL suggests the cause of this disease could be viral infection. For this reason, several viruses have been evaluated as possible etiologies of HNL, including Epstein-Barr virus (EBV), human herpesvirus 6 (HHV6), human herpesvirus 8 (HHV8), and cytomegalovirus (CMV). The aim of this study was to examine the relationship of EBV and HHV6 to HNL. Methods : Data pertaining to 51 cases with biopsy-confirmed HNL were collected between January 1999 and December 2005, from the Department of Pathology, College of Medicine, Pusan National University, Busan, Korea. The clinical records-including data regarding age, gender, duration of fever, and lymph node involvementwere reviewed retrospectively. The in situ hybridization (ISH) assay was performed by EBER PNA probe (Dako, Capinteria, CA, USA), and immunohistochemistry testing was performed with anti-HHV type 6 monoclonal antibodies (Chemicon, Temecula, CA, USA). Results : The HNL patients in this study were 24 males and 27 females, ranging in age from seven to 61 years (median: 25.9). ISH for EBV was positive in 8/51 (15.7%) biopsies, and immunohistochemistry for HHV6 was positive in 15/51 (29.4%) biopsies. Serologic analysis of EBV IgM was performed in 23 cases; only one patient was positive for EBV IgM and EBV ISH. Conclusion : Our study could not provide supportive evidence of a viral pathogenesis for HNL; therefore, cases of HNL may not have a dominant viral cause. However, some rare exceptional cases may have been caused by viral infection.

Hemophagocytic lymphohistiocytosis with recurrent Kikuchi-Fujimoto disease

  • Lee, Sang Min;Lim, Young Tae;Jang, Kyung Mi;Gu, Mi Jin;Lee, Jong Ho;Lee, Jae Min
    • Journal of Yeungnam Medical Science
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    • v.38 no.3
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    • pp.245-250
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    • 2021
  • Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a self-limiting lymphadenitis. It is a benign disease mainly characterized by high fever, lymph node swelling, and leukopenia. Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening disease with clinical symptoms similar to those of KFD, but it requires a significantly more aggressive treatment. A 19-year-old Korean male patient was hospitalized for fever and cervical lymphadenopathy. Variable-sized lymph node enlargements with slightly necrotic lesions were detected on computed tomography. Biopsy specimen from a cervical lymph node showed necrotizing lymphadenitis with HLH. Bone marrow aspiration showed hemophagocytic histiocytosis. The clinical symptoms and the results of the laboratory test and bone marrow aspiration met the diagnostic criteria for HLH. The patient was diagnosed with macrophage activation syndrome-HLH, a secondary HLH associated with KFD. He was treated with dexamethasone (10 mg/m2/day) without immunosuppressive therapy or etoposide-based chemotherapy. The fever disappeared within a day, and other symptoms such as lymphadenopathy, ascites, and pleural effusion improved. Dexamethasone was reduced from day 2 of hospitalization and was tapered over 8 weeks. The patient was discharged on day 6 with continuation of dexamethasone. The patient had no recurrence at the 18-month follow-up.

Kikuchi Disease Manifesting as Multifocal Lymphadenopathy and Splenomegaly: Ultrasonography, CT, and 18F-FDG PET/CT Findings Mimicking Lymphoma (다발성 림프절염과 비장종대로 발현하여 림프종으로 오인된 기쿠치병의 초음파, CT, 18F-FDG PET/CT 소견)

  • Moin Ha;Bo-Kyung Je;Eung-Seok Lee;Seong Wook Lee
    • Journal of the Korean Society of Radiology
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    • v.81 no.6
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    • pp.1486-1491
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    • 2020
  • Kikuchi disease is a type of benign, self-limiting necrotizing lymphadenitis that occurs most commonly in young women and usually manifests as palpable cervical lymph nodes and fever. Patients with an unusual location of lymph node involvement can be misdiagnosed with malignant disease. Here, we report a case of Kikuchi disease in a 15-year-old girl presenting with persistent fever for 2 weeks. Imaging studies, including ultrasonography, CT, and 18F-fluorodeoxyglucose PET/CT, revealed splenomegaly and enlarged lymph nodes in the neck, axilla, abdomen, retroperitoneum, and inguinal region. Laparoscopic excision of the celiac lymph nodes confirmed histiocytic necrotizing lymphadenitis, also known as Kikuchi disease. Conservative treatment with corticosteroids improved the patient's condition.

A Review of Subacute Necrotizing Lymphadenitis (아급성 괴사성 임파선염에 대한 임상적 관찰)

  • Jang, Chang-Hoon;Kwon, Soon-Seog;Kim, Young-Kyoon;Kim, Kwan-Hyoung;Han, Ki-Don;Moon, Hwa-Sik;Song, Jeong-Sup;Park, Sung-Hak
    • Tuberculosis and Respiratory Diseases
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    • v.38 no.3
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    • pp.297-303
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    • 1991
  • Subacute necrotizing lymphadenitis is characterized by cervical lymphadenpathy in young patients and mistaken for malignant disease both clinically and histologically. Microscopically, there is a varying degree of effacement of the lymph node architecture and necrosis with an infiltrate of histiocytic cells and absence of polymorphs. We have experienced 4 cases of cervical lymphadenopathy accompanied by fever. All cases had complete recovery to conservative treatment only. The excised lymph nodes were moderately enlarged and typically showed varying degree of necrotizing lesions, and abundant karyorrhectic debris, scattered fibrin deposits, aggregates of large mononuclear cells, and a paucity of plasma cell and neutrophils. For investigating the etiology and pathogenesis of this lesion, further clinical study and stepwise pathologic and immunologic planning would be valuable.

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A case of Kikuchi's disease with skin involvement (일과성의 홍반성 피부병변을 동반한 소아 Kikuchi병 1례)

  • Jang, Ji Min;Woo, Chul Hee;Choi, Jung Woo;Song, DaeJin;Yoo, Young;Lee, Kwang Chul;Son, Chang Sung
    • Clinical and Experimental Pediatrics
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    • v.49 no.1
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    • pp.103-106
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    • 2006
  • Histiocytic necrotizing lymphadenitis, which is also commonly referred to as Kikuchi's disease (KD), is a self-limiting disease of unknown etiology. It affects individuals of all ages, although it is usually seen in young women. However, only a few descriptions of this disease are available in the pediatric literature. KD is clinically characterized by cervical lymphadenopathy, high fever, myalgia, neutropenia and, rarely, cutaneous eruptions. Cutaneous manifestations have been reported in 16-40 percent of KD cases. The specific skin changes occurring in cases of KD have yet to be completely characterized. In most of the reported cases thus far, the lesions have been located on the face and upper extremities. In this report, we describe a case of pediatric Kikuchi's disease, occurring in a 9-year-old boy. The boy exhibited transient erythematous maculopapular skin lesions over the entirety of his body, including his lower extremities.

A CASE REPORT OF KIKUCHI-FUJIMOTO DISEASE (Kikuchi-Fujimoto Disease의 치험례)

  • Jang, Tae-Hwa;Kim, Jin-Wook;Kwon, Tae-Geon;Jang, Hyung-Jung;Kim, Chin-Soo;Lee, Sang-Han
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.29 no.6
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    • pp.548-553
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    • 2007
  • Kikuchi-Fujimoto disease is a rare disease first described in 1972 by Kikuchi and Fujimoto et al. The disease is described as a benign and unusual self-limiting histiocytic necrotizing lymphadenitis of unknown origin, which is characterized histologically by necrotic foci surrounded by histiocytic aggregates. is usually manifested with lymphadenopathy and high fever. This disease mostly affects young Asian women between 20 and 30 years of age and has rarely been reported in children. Main symptoms are indolent or light tender, enlarged lymph nodes in the neck area. The correct diagnosis requires the histologic examination of the lymph node. Kikuchi-Fujimoto disease is easily confused histologically and clinically with lymphoma and systemic lupus erythematosis histologically and clinically. Although it is an uncommon cause of fever of unknown origin, early recognition of KFD is very important and will minimize potentially harmful and unnecessary evaluations and treatments. We reported a case, a 23-year old man who had Kikuchi-Fujimoto disease with a literature review.

A case of Kikuchi-Fujimoto disease with autoimmune thyroiditis

  • Go, Eun Ji;Jung, You Jin;Han, Seung Beom;Suh, Byung Kyu;Kang, Jin Han
    • Clinical and Experimental Pediatrics
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    • v.55 no.11
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    • pp.445-448
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    • 2012
  • Kikuchi-Fujimoto disease (KFD) is a benign self-limiting disease characterized by fever and lymphadenitis. The etiology and pathogenesis of KFD is unclear. However, two hypotheses have been suggested: a viral infection hypothesis and an autoimmune hypothesis. Several KFD patients with various types of autoimmune diseases have been reported, and these reports support the hypothesis for autoimmune pathogenesis of KFD. Here, we report the case of a 17-year-old female patient diagnosed with KFD and autoimmune thyroiditis. This case serves as additional evidence that the etiology of KFD is autoimmune origin.

Kikuchi-Fujimoto disease with aseptic meningitis (무균성 뇌수막염을 동반한 Kikuchi-Fujimoto 병)

  • Park, Se Jin;Moon, Won Jin;Kim, Wan Seop;Kim, Kyo Sun
    • Clinical and Experimental Pediatrics
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    • v.52 no.5
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    • pp.622-626
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    • 2009
  • Kikuchi-Fujimoto disease was initially described as a self-limiting histiocytic necrotizing lymphadenitis in Japan in 1972, and is predominantly observed in women under the age of 30 year and in Asian populations. The pathogenesis is still poorly understood but is thought to include infections, and autoimmune and neoplastic diseases. The most common clinical manifestations are fever and painless cervical lymphadenitis. Diagnosis is based on the histopathological findings, characterized by focal necrosis in the paracortical region with abundant karyorrhexis, aggregates of atypical mononuclear cells around the zone of necrosis, absence of neutrophils and plasma cells, and usually intact lymph node capsule. There is no specific therapy for the condition, and aseptic meningitis can occur as one of the complications. Here, we report the case of a patient with Kikuchi-Fujimoto disease accompanied with aseptic meningitis, which may be confused as a case of tuberculous meningitis and lymphadenitis.