No abstract available.
Diagnosis* ; Exanthema* ; Lymphadenitis* ; Scrub Typhus*

Kikuchi's disease is a benign self-limiting necrotizing lymphadenitis that occurs most commonly in young women, and is usually found in the cervical lymph nodes. When there is an unusual location of involved lymph nodes, the diagnosis can be difficult. We recently treated a patient with Kikuchi's disease who had ileocecal mesenteric lymph node involvement; the patient presented with symptoms of acute appendicitis in an 11-year old boy. Although mesenteric lymph node involvement of Kikuchi's disease is very rare, Kikuchi's disease should be added to the differential diagnosis of acute appendicitis in patients with enlarged ileocecal mesenteric lymph nodes on radiological evaluation.
Appendicitis* ; Child ; Diagnosis ; Diagnosis, Differential ; Female ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Lymph Nodes* ; Lymphadenitis ; Male ; Mesentery

Histiocytic necrotizing lymphadenitis is a benign disorder of the lymph node which should be differentiated from other types of lymphadenitis or malignant lymphoma. The most common presentation includes fever and cervical lym-phadenopathy .The course is invariably benign and spontaneous resolution usually occurs within 4 to 6 months. The diagnosis is confirmed by characteristic pathological findings of the involved lymph node. The involvement of the ner-vous system is known to be rare. We report two patients with histiocytic necrotizing lymphadenitis accompanied by aseptic meningitis. In one patient, both diseases developed simultaneously and in the other patient, histiocytic necrotiz-ing lymphadenitis was followed by aseptic meningitis 2 months later.
Diagnosis ; Fever ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Lymph Nodes ; Lymphadenitis ; Lymphoma ; Meningitis, Aseptic* ; Nervous System

BACKGROUND: Although Kikuchi's lymphadenitis (KL) has been known to have characteristic cytological features, pathologists encounter difficulties in making a diagnosis with fine needle aspiration cytology (FNAC). The objective of this study was to assess the diagnostic pitfalls of KL with FNAC, particularly with emphasis on differential diagnosis with tuberculosis. METHODS: FNAC of 10 patients with a histological diagnosis of KL and tuberculosis was reviewed. RESULTS: Acidophilic cells were observed in all the 10 KL cases, even if the smears were insufficient. Crescentic histiocytes were seen in 8, granular background in 7, and karyorrhectic debris in 3 cases. Epithelioid histiocytes or neutrophils were not seen in any of the KL cases. Of the 10 cases of tuberculosis, acidophilic cells were observed in 6 cases, crescentic histiocytes in none of them, cheese-like background in 9, karyorrhectic debris in 8, epithelioid histiocytes in 4, and neutrophils in 8 cases. CONCLUSIONS: The acidophilic cell could be the most sensitive but not the specific marker of KL with FNAC. The crescentic histiocytes might be the sensitive and considerably specific marker of KL. The cytological features distinguishing tuberculosis from KL may be cheese-like necrosis admixed with neutrophils and epithelioid histiocytes.
Biopsy, Fine-Needle ; Diagnosis, Differential ; Histiocytes ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Lymphadenitis ; Necrosis ; Neutrophils ; Tuberculosis

Kikuchi-Fujimoto disease (KFD) is a rare self-limiting necrotizing lymphadenitis found mainly in young women. Patients typically present with lymphadenopathy and often with a high temperature. The etiology of the disease remains unknown, but various viral infection and autoimmune processes have been postulated to be the cause. One theory proposes that KFD may be a self-limiting form of systemic lupus erythematosus (SLE). This theory is strongly supported by the fact that microscopic features of KFD can be very similar to those found in lupus lymphadenitis. The diagnosis of KFD can precede, postdate or coincide with the diagnosis of SLE. No treatment is usually needed and relapse, although possible, is uncommon. Our case describes a young woman, originally diagnosed as having SLE, who subsequently developed recurrent KFD with axillary lymphadenopathy and fever.
Diagnosis ; Female ; Fever ; Histiocytic Necrotizing Lymphadenitis* ; Humans ; Lupus Erythematosus, Systemic ; Lymphadenitis ; Lymphatic Diseases ; Recurrence

Kikuchi's disease and hemophagocytic syndrome have the clinical similarity in initial presentations, but present different clinical course and prognosis. Kikuchi's disease usually have a self-limiting clinical course, but hemophagocytic syndrome can be fatal. It is important to make differential diagnoses and treat properly. We report a case of 18 year old boy who was admitted to the hospital with two weeks history of fever and progressive cervical lymph node swelling. Cervical lymph node biopsy showed the typical necrotizing lymphadenitis of Kikuchi's disease. There were signs of histiocytosis and hemophagocytic phenomenon in the bone marrow. The etiology, treatment, and prognosis of Kikuchi's disease with hemophagocytic syndrome are discussed.
Biopsy ; Bone Marrow ; Diagnosis, Differential ; Fever ; Histiocytic Necrotizing Lymphadenitis ; Histiocytosis ; Lymph Nodes ; Lymphadenitis ; Lymphohistiocytosis, Hemophagocytic ; Prognosis

Cervical lymphadenitis is one of the common causes which make the patients visit the outpatient clinic. Extensive differential diagnoses are required to identify causative illness including viral or bacterial infection, Kikuchi's disease, tuberculosis, etc. In this review, several important key points are discussed with regards to clinical course, pathological diagnosis and treatment in patients with cervical lymphadenitis.
Ambulatory Care Facilities ; Bacterial Infections ; Communicable Diseases ; Diagnosis, Differential ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Lymphadenitis ; Specialization ; Tuberculosis

Cervical lymphadenitis is one of the common causes which make the patients visit the outpatient clinic. Extensive differential diagnoses are required to identify causative illness including viral or bacterial infection, Kikuchi's disease, tuberculosis, etc. In this review, several important key points are discussed with regards to clinical course, pathological diagnosis and treatment in patients with cervical lymphadenitis.
Ambulatory Care Facilities ; Bacterial Infections ; Communicable Diseases ; Diagnosis, Differential ; Histiocytic Necrotizing Lymphadenitis ; Humans ; Lymphadenitis ; Specialization ; Tuberculosis

PURPOSE: To evaluate the vascular pattern of lymph nodes, and the usefulness of color Doppler sonogaphy indifferentiating benign from malignant superficial lymphadenopathy. MATERIALS AND METHODS: Twenty-six patientswere pathologically and clinically confirmed to be suffering from benign reactive lymphadenitis and tuberculosis(n=16) or lymphoma and malignant lymphadenitis (n=10). Lymph node shape was assessed by the ratio of longitudinaldiameter to transverse diameter(L/T), and patients were thus assigned to one of two groups : L/T >or =2, or L/T<2.The hilar vascular pattern of lymph node was assessed by color Doppler sonography and classified as central,eccentric, or absent. On the basis of peripheral vascularity, patients were divided into three groups according tocircumferental linear vascularity. An absence of peripheral vascularity was classified as grade 0. If less thanhalf the periphery was covered by linear vascularity, a patient was assigned to as grade I, and if more than halfwas covered by a vessel, the classification was grade II. RESULTS: Statistically significant differences in L/Tratio were noted between malignant and benign node (p<.001). Of the 16 benign reactive nodes, 13 showed L/T >or =2,and 3 L/T<2. while in nine of the ten malignant nodes, L/T<2 was noted. Among 16 benign reactive nodes, hilarvascularity was central in 13, eccentric in one, and absent in two. Among the ten malignant nodes, thecorresponding totals were nil, four, and Six. The hilar vascular pattern showed statistically significantdifferentiation between malignant and benign node (p<.05). Among 16 benign reactive nodes, 13 were grade 0, twowere grade I, and one was grade II, while among ten malignant nodes, two were grade 0 and eight were grade I. Onthe basis of vascular pattern, the difference between benign and malignant nodes was statistically significant(p<.05). CONCLUSION: L/T ratio<2, absent or eccentric hilar vascularity, and the presence of peripheralvascularity are suggestive of malignant lymph node. The shape of LN and pattern revealed by an analysis of nodalvascularity using color Doppler sonography are useful in differential diagnosis of benign and malignantlymphadenopathy.
Classification ; Diagnosis, Differential ; Humans ; Lymph Nodes ; Lymphadenitis ; Lymphatic Diseases* ; Lymphoma

Bacteremia ; diagnosis ; Glomerulonephritis ; diagnosis ; Humans ; Lymphadenitis ; diagnosis ; Male ; Pneumococcal Infections ; diagnosis