• Pediatric Infection and Vaccine
• /
• v.4 no.1
• /
• pp.150-154
• /
• 1997

Since 1972, a unique lymphadenitis called as subacute necrotizing lymphadenitis has been described in many Japanese literature. Originally described in Japan, it now appears worldwide. It mainly affects young women and usually manifests as fever and lymphdenopathy. The pathology is characterized by necrosis with loss of nodal architecture, infiltration with many histiocytes, and an absence of granulocytes. We report a case of subacute necrotizing lymphadenitis in axillary area. 4 10-year-old male child was admitted with a one-month history of fever, swelling in the axillary area. He treated with intravenous antibiotics. Despite treatment he remained febrile for the next ten days. 4 dissection of the axillary swelling was then performed, as was a diagnostic lymph node biopsy. The patient's condition resolved over several days and he was discharged.

• Pediatric Infection and Vaccine
• /
• v.10 no.1
• /
• pp.123-126
• /
• 2003

Kikuchi disease(subacute necrotizing lymphadenitis), first reported by Kikuchi and Fujimoto in 1972, is a benign self-limiting illness characterized by fever, neutropenia and cervical lymphadenopathy and develops predominantly in young women, especially in Asia. The cause of Kikuchi disease is unknown, but postinfectious(virus or bacteria) hyperimmune reaction has been suggested. Few pediatric cases have been reported. We experienced a case of Kikuchi disease associated with Yersinia pseudotuberculosis infection in 12-year-old girl. After she was admitted with cervical lymphadenopathy and headache, followed by sustained fever with leukopenia. All symptoms and signs did not seem to be responded to antimicobial treatment. Open biopsy of cervical lymph node was performed and showed findings consistent with subacute necrotizing lymphadenitis. Serologic studies were all negative except for Y. pseudotuberculosis. Fever subsided and lymphadenopathy improved after administration of oral steroid for 1 week.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.3 no.2
• /
• pp.212-216
• /
• 2000

Subacute necrotizing lymphadenitis was first reported by Kikuchi and Fujimoto in 1972. Young females no more than 30 years of age are mainly affected. It usually manifests as fever and cervical lymphadenopathy. We experienced one case of subacute necrotizing lymphadenitis with hepatic complication in an 11-year-old boy. Symptoms presented were URI signs, diarrhea, headache, and weight loss along with fever and cervical lymphadenopathy. Elevated serum AST/ALT levels were also noted up to 682/1560 (IU/L) and were normalized within one month. We performed aspiration biopsy of the liver twice (at admission and 5 months thereafter). The hepatic histopathologic findings were nonspecific.

• Pediatric Infection and Vaccine
• /
• v.8 no.1
• /
• pp.118-122
• /
• 2001

Since the first description of Kikuchi disease(Subacute necrotizing lymphadenitis) in Japan, 1972, this condition has been reported in a worldwide. The etiology remains unknown. This disease shows a marked predilection for young woman, and a few cases in children has been reported. The usual initial clinical manifestation is localized cervical lymphadenopathy with fever, weight loss and myalgia. We experienced a 6 year-old girl of subacute necrotizing lymphadenitis with ANA, therefore report a brief review with the related literatures.

• Korean Journal of Bronchoesophagology
• /
• v.6 no.1
• /
• pp.21-28
• /
• 2000

Background:Subacute necrotizing lymphadenitis or Kikuchi's disease is unknown ethiology and self-limiting process. This disease predominantly affects young women age but rarely affects pediatrics, and usually manifests as lymphadenopathy and fever. Even though this disease is self-limited, benign process, many cases are misidentified as malignant lymphoma. The purpose of this study is to report the clinicopathologic finding, radiological finding and many labolatory test and to compare with characteristics of adult patients in this disease. Meterial and Methods:We reviewed 27 pediarics patients with subacute necrotizing lymphadenitis by excision biopsy or fineneedle aspiration cytology.Result:The most common symptomes were palpation of cervical lymh node(88.9%) and fever(66.7%). The common site of the involvement was cervical lymph node. The multiple involvement was 93% and bilateral involvement was 59%. Leukopenia(52%) and elevated erythrocyte sedimentation rates(93%) appeared in abnormal laboratory data. Microscopically, the characteristic finding was the wide area of florid nuclear dusts engulfed by histiocytes and well-circumscrbed area with eosinophilic fibrinoid material. There was a striking degree ofkaryorrhexis and an absence of granulocyte with paucity of plasma cell. All patients recovered with the conservative treatment and there was no specific complication and recurrence. Conclusion : We reviewed pediatric patients with this disease. Characteristics of this disease inpediatric patients were similar to adult patients.

• Korean Journal of Head & Neck Oncology
• /
• v.19 no.2
• /
• pp.133-136
• /
• 2003

Background and Objectives: Kikuchi's disease or subacute necrotizing lymphadenitis is a cause of persistently enlarged lymph nodes unresponsive to antibiotic therapy. It affects predominantly young women under the age of 30, and it is seen primarily in the Asian population. Although this disease usually follows a benign course, all describing a clinical entity that has been mistaken for malignant lymphoma, lupus, and an assortment of infectious diseases. The purpose of this study is to report clinical characteristics and treatment outcome in order to contribute to the precise diagnosis and treatment. Materials and Methods: We reviewed 27 cases, who were diagnosed as subacute necrotizing lymphadenitis on excisional biopsy during the past 5 years from January 1998 to December 2002. Results: It occurred more often in females (20 cases ; 74%) than males (7cases ; 26%), and it was seen more frequently in the second and third decades (21 cases ; 78%). Cervical lymphadenopathy were usually multiple (24 cases, 89%) and measured less than 2cm (20 cases, 74%). The posterior cervical and deep jugular chains are the most common location(34 cases ; 81%). Leukopenia(18 cases, 67%) and elevated ESR(20 cases, 75%) were commonly noted in laboratory data. Conclusions: It is easy that Kikuchi's disease is mistaken for malignant lymphoma. So we should consider fine needle aspiration or open biosy of lymph node for histologic diagnosis in patients who have localized cervical lymphadenopathy unresponsive to antibiotic therapy.

• Korean Journal of Head & Neck Oncology
• /
• v.15 no.2
• /
• pp.217-221
• /
• 1999

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.

• The Korean Journal of Cytopathology
• /
• v.5 no.1
• /
• pp.23-27
• /
• 1994

Three cases of subacute necrotizing lymphadenitis diagnosed by fine needle aspiration (FNA) of enlarged lymph nodes are reported. The FNA smears contained randomly activated lymphoid cells, necrotic debris and histiocytes. The same patterns were found in subsequently examined excised lymph nodes from these cases. The differential diagnosis of this entity is discussed and the value of preparing FNA cell blocks and accompanying AFB stain with culture is emphasized. FNA may be able to provide a diagnosis in case of this benign disease, therefore avoiding a more traumatic excisional biopsy.

• Annals of Clinical Neurophysiology
• /
• v.9 no.2
• /
• pp.93-96
• /
• 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).

• Clinical and Experimental Pediatrics
• /
• v.51 no.11
• /
• pp.1198-1204
• /
• 2008

Purpose : The cause of subacute necrotizing lymphadenitis, a rare disease in children, has not been completely clarified. This study was aimed to investigate the disease mechanism by examining clinical, radiologic, and immunohistochemical findings in children diagnosed with subacute necrotizing lymphadenitis after an excisional biopsy. Methods : We examined 19 lymph node tissue specimens from 17 children diagnosed with subacute necrotizing lymphadenitis at Gyeongsang National University Hospital from March, 1998 to July, 2006. A retrospective survey of the medical records was performed. CT findings were analyzed. Immunohistochemical staining was done on tissues obtained by excisional biopsy from all patients. Results : The patient's age ranged from 5 to 19 years (average age :11.8 years). The main symptoms included a neck mass (17/19), pain in the mass (6/17), and fever (12/19). The palpable lymph nodes were mostly cervical in location; the maximum diameter, which was measured radiologically, was less than 3 cm in all 10 cases. The masses were pathologically divided into proliferative, necrotic, and xanthomatous types. With immunohistochemical staining the masses were divided into lesion (L), perilesion (PL), and necrosis (N). The CD8 staining was stronger than the CD4 staining for all regions in three types. The CD4 staining intensity was mainly increased in the perilesion, and CD8 was mainly increased in the lesion. Conclusion : We compared the radiologic findings, clinical symptoms, and pathology to help understand the cause of disease in patients with subacute necrotizing lymphadenitis.