• Korean Journal of Bronchoesophagology
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• v.6 no.1
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• pp.21-28
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• 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
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• v.19 no.2
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• pp.133-136
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• 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.

• 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.