Difference between revisions of "Kikuchi disease"
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'''Kikuchi disease''', is a rare [[lymph node pathology]]. | |||
It is also known as '''histiocytic necrotising lymphadenitis''',<ref name="pmid15570824">{{cite journal |author=Kaushik V, Malik TH, Bishop PW, Jones PH |title=Histiocytic necrotising lymphadenitis (Kikuchi's disease): a rare cause of cervical lymphadenopathy |journal=Surgeon |volume=2 |issue=3 |pages=179–82 |year=2004 |month=June |pmid=15570824 |doi= |url=}}</ref> abbreviated '''HNL''', and '''Kikuchi-Fujimoto disease'''. | |||
==General== | |||
*Rare disease that may mimic [[cancer]], esp. [[lymphoma]]. | |||
**May cause fever & systemic symptoms.<ref name=pmid20121621>{{cite journal |author=Hutchinson CB, Wang E |title=Kikuchi-Fujimoto disease |journal=Arch. Pathol. Lab. Med. |volume=134 |issue=2 |pages=289–93 |year=2010 |month=February |pmid=20121621 |doi= |url=}}</ref> | |||
Epidemiology:<ref name=pmid20121621/> | |||
*Usually <40 years old. | |||
*Asian. | |||
*Female:Male = 3:1.<ref>URL: [http://emedicine.medscape.com/article/210752-overview http://emedicine.medscape.com/article/210752-overview]. Accessed on: 3 June 2010.</ref> | |||
Treatment: | |||
*Usually self-limited.<ref name=pmid20121621/> | |||
*Oral corticosteroids. | |||
DDx: | |||
*Non-Hodgkin lymphoma. | |||
*[[Systemic lupus erythematosus]]. | |||
**Have ''hematoxyphil bodies'' in necrotic foci. | |||
***Dark blue irregular bodies on H&E. | |||
==Micrograph== | |||
Features (the three main features - just as the name suggests):<ref>URL: [http://www.ispub.com/journal/the_internet_journal_of_head_and_neck_surgery/volume_1_number_1_30/article_printable/kikuchi_s_lymphadenitis_in_a_young_male.html http://www.ispub.com/journal/the_internet_journal_of_head_and_neck_surgery/volume_1_number_1_30/article_printable/kikuchi_s_lymphadenitis_in_a_young_male.html]. Accessed on: 1 June 2010.</ref> | |||
*Histiocytes. | |||
**May be crescentic. | |||
*Necrosis (due to [[apoptosis]]) - paracortical areas.<ref name=pmid20121621/> | |||
**[[Necrosis]] without neutrophils - '''key feature'''. | |||
*Lymphocytes (CD8 +ve). | |||
*Plasmacytoid dendritic cells. | |||
Notes: | |||
*Dendritic cell - vaguely resembles a macrophage:<ref>URL: [http://www.healthsystem.virginia.edu/internet/hematology/hessedd/benignhematologicdisorders/normal-hematopoietic-cells/dendritic-cell.cfm?drid=214 http://www.healthsystem.virginia.edu/internet/hematology/hessedd/benignhematologicdisorders/normal-hematopoietic-cells/dendritic-cell.cfm?drid=214]. Accessed on: 3 June 2010.</ref> | |||
**Long membrane projections - '''key feature'''. | |||
**Abundant blue-grey cytoplasm, +/- ground-glass appearance. | |||
**Nucleus: small, ovoid, usu. single nucleolus. | |||
===Images=== | |||
<gallery> | |||
Image:Histiocytic_necrotizing_lymphadenitis_-_intermed_mag.jpg | Kikuchi disease - intermed. mag. (WC) | |||
Image:Histiocytic_necrotizing_lymphadenitis_-_high_mag.jpg | Kikuchi disease - high mag. (WC) | |||
Image:Histiocytic_necrotizing_lymphadenitis_-_very_high_mag.jpg | Kikuchi disease - very high mag. (WC) | |||
</gallery> | |||
www: | |||
*[http://path.upmc.edu/cases/case200.html Kikuchi disease - several crappy images (upmc.edu)]. | |||
==IHC== | |||
*CD68 +ve. | |||
*CD8 +ve - usu. predominant. | |||
*CD4, CD20, CD3, and CD30 - mixed. | |||
**Done to excluded lymphoma; esp. large cell lymphomas;<ref name=pmid19577167>{{cite journal |author=Good DJ, Gascoyne RD |title=Atypical lymphoid hyperplasia mimicking lymphoma |journal=Hematol. Oncol. Clin. North Am. |volume=23 |issue=4 |pages=729–45 |year=2009 |month=August |pmid=19577167 |doi=10.1016/j.hoc.2009.04.005 |url=}}</ref> should show a mixed population of lymphocytes. | |||
*Others: | |||
**CD56 -ve. | |||
==See also== | |||
*[[Lymph node pathology]]. | |||
*[[Necrosis]]. | |||
==References== | |||
{{Reflist|2}} | |||
[[Category:Lymph node pathology]] | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
Revision as of 03:14, 10 December 2013
Kikuchi disease, is a rare lymph node pathology.
It is also known as histiocytic necrotising lymphadenitis,[1] abbreviated HNL, and Kikuchi-Fujimoto disease.
General
Epidemiology:[2]
- Usually <40 years old.
- Asian.
- Female:Male = 3:1.[3]
Treatment:
- Usually self-limited.[2]
- Oral corticosteroids.
DDx:
- Non-Hodgkin lymphoma.
- Systemic lupus erythematosus.
- Have hematoxyphil bodies in necrotic foci.
- Dark blue irregular bodies on H&E.
- Have hematoxyphil bodies in necrotic foci.
Micrograph
Features (the three main features - just as the name suggests):[4]
- Histiocytes.
- May be crescentic.
- Necrosis (due to apoptosis) - paracortical areas.[2]
- Necrosis without neutrophils - key feature.
- Lymphocytes (CD8 +ve).
- Plasmacytoid dendritic cells.
Notes:
- Dendritic cell - vaguely resembles a macrophage:[5]
- Long membrane projections - key feature.
- Abundant blue-grey cytoplasm, +/- ground-glass appearance.
- Nucleus: small, ovoid, usu. single nucleolus.
Images
Kikuchi disease - intermed. mag. (WC)
Kikuchi disease - high mag. (WC)
Kikuchi disease - very high mag. (WC)
www:
IHC
- CD68 +ve.
- CD8 +ve - usu. predominant.
- CD4, CD20, CD3, and CD30 - mixed.
- Done to excluded lymphoma; esp. large cell lymphomas;[6] should show a mixed population of lymphocytes.
- Others:
- CD56 -ve.
See also
References
- ↑ Kaushik V, Malik TH, Bishop PW, Jones PH (June 2004). "Histiocytic necrotising lymphadenitis (Kikuchi's disease): a rare cause of cervical lymphadenopathy". Surgeon 2 (3): 179–82. PMID 15570824.
- ↑ 2.0 2.1 2.2 2.3 Hutchinson CB, Wang E (February 2010). "Kikuchi-Fujimoto disease". Arch. Pathol. Lab. Med. 134 (2): 289–93. PMID 20121621.
- ↑ URL: http://emedicine.medscape.com/article/210752-overview. Accessed on: 3 June 2010.
- ↑ URL: http://www.ispub.com/journal/the_internet_journal_of_head_and_neck_surgery/volume_1_number_1_30/article_printable/kikuchi_s_lymphadenitis_in_a_young_male.html. Accessed on: 1 June 2010.
- ↑ URL: http://www.healthsystem.virginia.edu/internet/hematology/hessedd/benignhematologicdisorders/normal-hematopoietic-cells/dendritic-cell.cfm?drid=214. Accessed on: 3 June 2010.
- ↑ Good DJ, Gascoyne RD (August 2009). "Atypical lymphoid hyperplasia mimicking lymphoma". Hematol. Oncol. Clin. North Am. 23 (4): 729–45. doi:10.1016/j.hoc.2009.04.005. PMID 19577167.