OBJECTIVETo study the clinical manifestation, pathologic features and immunophenotype of histiocytic necrotizing lymphadenitis (HNL).

METHODSThe clinicopathologic data of 84 patients with HNL from 2005 to 2014 were retrospectively studied. Immunohistochemical staining using EliVision method for CD20, PAX5, CD3, CD45RO, CD4, CD8, CD56, CD68, CD123, granzyme-B, TIA1 and MPO was carried out. In-situ hybridization for Epstein-Barr virus RNA was performed on archival lymph node biopsy tissue.

RESULTSImmunohistochemical study showed that the lesional cells were predominantly histiocytes (CD68+), plasmacytoid dendritic cells (CD123+) and T lymphocytes (CD3+ and CD45RO+). Clusters of CD68-positive cells with strong and diffuse MPO expression were identified. T lymphocytes with CD4 and CD8 positivity were noted. CD56+ natural killer cells and CD20+/PAX5 B cells were rare. Apoptosis-related markers, including TIA1 and granzyme B were expressed by T lymphocytes and histiocytes in lymph nodes of HNL. In-situ hybridization for Epstein-Barr virus RNA was positive in only 10.0% of the cases.

CONCLUSIONSHNL shows no specific clinical and laboratory findings. Recognition of the characteristic histopathologic changes in lymph node biopsy of HNL is the key to correct diagnosis. Immunohistochemical study using a panel of markers, including CD3, CD4, CD8, MPO, CD123, granzyme-B and TIA1, is helpful in the differential diagnosis of HNL.

Antigens, CD ; analysis ; Biomarkers ; Dendritic Cells ; pathology ; Diagnosis, Differential ; Granzymes ; analysis ; Herpesvirus 4, Human ; genetics ; Histiocytes ; pathology ; Histiocytic Necrotizing Lymphadenitis ; complications ; immunology ; pathology ; virology ; Humans ; Immunohistochemistry ; Immunophenotyping ; In Situ Hybridization ; methods ; Lymph Nodes ; RNA, Viral ; analysis ; Retrospective Studies ; T-Lymphocytes ; immunology ; pathology

Adult ; Female ; Humans ; Lymphadenitis ; complications ; diagnosis ; pathology ; Positron-Emission Tomography ; Urticaria ; etiology ; Vitiligo ; etiology

Pneumococcal glomerulonephritis is rarely described in the literature. We report a four-year-old boy who developed acute glomerulonephritis following pneumococcal bacteraemia and submandibular lymphadenitis, and review the published literature. Two weeks after developing acute glomerulonephritis, the patient developed bronchopneumonia with left pleural effusion. However, by the fourth week of admission, his renal function had normalised and lung involvement resolved.
Acute Disease ; Anti-Bacterial Agents ; therapeutic use ; Bacteremia ; complications ; diagnosis ; Biopsy ; Child, Preschool ; Glomerulonephritis ; complications ; diagnosis ; Humans ; Lymphadenitis ; complications ; diagnosis ; Male ; Pleural Effusion ; Pneumococcal Infections ; complications ; diagnosis ; Treatment Outcome

Child ; Female ; Histiocytic Necrotizing Lymphadenitis ; complications ; Humans ; Lupus Erythematosus, Systemic ; etiology ; Lupus Nephritis ; complications

We report a case of cat scratch disease in an 8-yr-old girl who presented with fever and enlargement of both axillary lymph nodes. Both aerobic and anaerobic cultures of the lymph node aspirate were negative for microbial growth. Gram staining and Warthin-Starry silver staining did not reveal any organism. Purified DNA from the PCR-amplicon of the 16S-23S rRNA intergenic region was sequenced and showed 99.7% identity with the corresponding sequence of Bartonella henselae strain Houston-1. Our findings suggest that the internal transcribed spacer is a reliable region for PCR identification of Bartonella species. In patients with lymphadenitis, a history of contact with cats or dogs necessitates the use of diagnostic approaches that employ not only the conventional staining and culture but also molecular methods to detect B. henselae.
Animals ; Bartonella henselae/genetics/*isolation & purification ; Cat-Scratch Disease/complications/*diagnosis ; Cats ; Child ; Dogs ; Female ; Humans ; Lymphadenitis/complications ; *Polymerase Chain Reaction ; RNA, Ribosomal, 16S/*genetics ; RNA, Ribosomal, 23S/*genetics ; Republic of Korea ; Sequence Analysis, DNA

BCG Vaccine ; adverse effects ; Child ; Child, Preschool ; Genetic Diseases, X-Linked ; complications ; Granulomatous Disease, Chronic ; complications ; genetics ; Humans ; Infant ; Infant, Newborn ; Lymphadenitis ; etiology ; Male ; Membrane Glycoproteins ; genetics ; NADPH Oxidase 2 ; NADPH Oxidases ; genetics

Adult ; Diagnosis, Differential ; Exanthema ; etiology ; Histiocytic Necrotizing Lymphadenitis ; complications ; diagnosis ; Humans ; Lymphatic Diseases ; etiology ; Male

Adolescent ; Antibodies, Antinuclear ; blood ; Child ; Histiocytic Necrotizing Lymphadenitis ; etiology ; Humans ; Lupus Erythematosus, Systemic ; complications ; Male ; Sjogren's Syndrome ; complications

Atrioventricular Block ; complications ; Child ; Electromyography ; instrumentation ; methods ; Female ; Histiocytic Necrotizing Lymphadenitis ; complications ; Humans ; Research Report ; Thrombocytopenia ; complications

Cryptococcal infection is a rare, yet well recognized complication of systemic lupus erythematosus (SLE). We present a case of mesenteric and retroperitoneal cryptococcal lymphadenitis resulting in the obstruction of the stomach and proximal duodenum in a patient suffering from SLE, while recently she did not receive any immunosuppressive treatment. A 42-yr-old woman was admitted due to high fever and diffuse abdominal pain for three weeks. Abdominal computed tomography (CT) scan showed multiple conglomerated lymphadenopathies in the retroperitoneum and the mesentery resulting in luminal narrowing of the third portion of the duodenum. Cryptococcal lymphadenitis was proven by needle biopsy and she was treated with intravenous liposomal amphotericin B, followed by oral fluconazole. After fourteen-month antifungal therapies, the clinical symptoms and follow-up images improved. This case emphasize that the intrinsic immunological defects of SLE may be directly responsible for the predisposition to fungal infections.
Adult ; Cryptococcosis/*etiology/pathology/radiography ; Female ; Humans ; Lupus Erythematosus, Systemic/*complications/immunology ; Lymphadenitis/*etiology/pathology/radiography ; Mesentery ; Opportunistic Infections/etiology/pathology/radiography ; Research Support, Non-U.S. Gov't ; Retroperitoneal Space ; Tomography, X-Ray Computed