• 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.

• Proceedings of the KOR-BRONCHOESO Conference
• /
• 1993.05a
• /
• pp.110-110
• /
• 1993

Necrotizing lymphadenitis, or Kikuchi's disease, a newly recognized disease of unknown origin, occurred usually in young woman and mostly resolved spontaneously without treatment within a few months. Clinically, characteristic symptoms and sings were local lymph node enlargement, sometimes accompanied by tenderness, fever, weightless, leukopenia, and elevated erythrocyte sedimentation rate, and so necrotizing lymphadenitis can be confused with malignant lymphoma and tuberculosis. The histologic features of necrotizing lymphadenitis are distinctive. : lymph node biopsy reveals areas with frank cellular necrosis, karyorrhexis, and absence of plasma cell. We present nineteen cases of necrotizing lymphadenitis during from March 1990 to January 1993 and discuss their exact diagnosis and proper treatment.

• 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 Environmental Biology
• /
• v.41 no.3
• /
• pp.223-228
• /
• 2023

Neoporphyra kitoi Ma. Abe, N. Kikuchi, Tamaki, Tom. Sato, Murase, Fujiyoshi & Mas. Kobayashi has been known as an endemic species in Japan. Its high temperature tolerance suggests that it could be advantageous for cultivation. In this study, we collected it from the Ulleungdo island, Korea and transferred it into Pyropia for a new combination, identified as Pyropia kitoi(Ma. Abe, N. Kikuchi, Tamaki, Tom. Sato, Murase, Fujiyoshi & Mas. Kobayashi) D.J. Kim, T.O. Cho & B.Y. Won comb. nov. based on morphological and molecular analyses. Pyropia kitoi is also reported as a new record species in the list of Korean macroalgal flora. Although we didn't observe the emergence of new blades from the rhizoidal cells, which is a key character for this species, our molecular analysis of rbcL revealed that our samples from Korea were congruent with "Neoporphyra kitoi" from Japan and were nested within the clade of Pyropia. The gene sequence divergence between the Korean and Japanese samples was 0-0.2%.

• Clinical and Experimental Pediatrics
• /
• v.57 no.5
• /
• pp.226-231
• /
• 2014

Purpose: Kikuchi-Fujimoto disease (KFD) is a benign disease, which is characterized by a cervical lymphadenopathy with fever, and it often mimics malignant lymphoma (ML). 2-[$^{18}F$]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ($^{18}F$-FDG PET/CT) is a powerful imaging modality for the diagnosis, staging and monitoring of ML, with the limitations including the nonspecific FDG uptake in infectious or inflammatory processes. This study compared clinical manifestations and PET/CT findings between KFD and ML patients. Methods: We retrospectively reviewed the medical records of 23 patients with KFD and 33 patients with ML, diagnosed histopathologically, between January 2000 and May 2013 at the Department of Pediatrics, Yeungnam University Medical Center. Among them, we analyzed the clinical manifestations, laboratory findings and characteristics, and the amount of $^{18}F$-FDG uptake between 8 KFD and 9 ML patients who had $^{18}F$-FDG PET/CT. Results: The $^{18}F$-FDG PET/CT maximum standardized uptake values ($SUV_{max}$) ranged from 8.3 to 22.5 (mean, 12.0) in KFDs, and from 5.8 to 34.3 (mean, 15.9) in MLs. There were no significant differences in $SUV_{max}$ between KFDs and MLs. $^{18}F$-FDG PET/CT with ML patients showed hot uptakes in the extranodal organs, such as bone marrow, small bowel, thymus, kidney, orbit and pleura. However, none of the KFD cases showed extranodal uptake (P<0.001). $^{18}F$-FDG PET/CT findings of KFD with nodal involvement only were indistinguishable from those of ML. Conclusion: Patients who had extranodal involvement on PET/CT were more likely to have malignancy than KFD.

• Pediatric Infection and Vaccine
• /
• v.8 no.2
• /
• pp.253-259
• /
• 2001

Kikuchi's disease(histiocytic necrotizing lymphadenitis) is characterized by lymphadenopathy in young patients below 30 years old, and persistent fever, lymphopenia and splenomegaly are concomitantly developed in many cases. So, it has been confused with lymphoma, SLE, and tuberculosis, and has easily led to inappropriate diagnostic procedures and administration of drugs. Many reports have indicated that Kikuchi's disease should be added to the list of causes of FUO in the setting of lymphadenopathy, and recommended early lymph node biopsy to distinguish from lymphoma, SLE, and tuberculosis to avoid unnecessary treatments. We experienced a case of subacute necrotizing lymphadenitis in a 14-year-old boy who presented with persistent high fever, productive coughing and cervical lymphadenopathy for about 1 month. Initially, diagnostic workup was done to look for the causes of FUO in vain. Finally, we confirmed diagnosis by histopathological findings of lymph node biopsy and detected latent gene of EBV in the biopsied specimen using in situ hybridization.

• Clinical and Experimental Pediatrics
• /
• v.51 no.9
• /
• pp.987-991
• /
• 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.

• Clinical and Experimental Pediatrics
• /
• v.50 no.3
• /
• pp.292-297
• /
• 2007

Purpose : Kawasaki disease (KD) rarely occurs in school-aged children. We clarified the characteristics of KD in this age group to provide tips for a high index of suspicion. Methods : Features of 38 patients with KD who were 7 years of age or older were retrospectively reviewed. Results : The incidence of the KD patients ${\geq}7years$ was 4.9 percent. The ratio of male to female was 2.5:1. Of the 38 patients, nine patients (24.0 percent) were diagnosed with typical KD and 29 patients (76.0 percent) with incomplete KD. In incomplete KD patients, cervical lymphadenopathy (69.0 percent) occurred most frequently, followed by conjunctival injection (62.0 percent) and polymorphous rash (45.0 percent). These patients occasionally presented with other additional symptoms including abdominal pain, headache, vomiting and arthralgia. Incomplete KD was initially diagnosed as cervical lymphadenitis (34.0 percent), viral infection (14.0 percent), scarlet fever (7.0 percent), meningitis (7.0 percent), and Kikuchi disease (7.0 percent). Coronary complications were noted in 15 patients (39.0 percent). Of the 37 patients treated with intravenous immunoglobulin, five (14.0 percent) were resistant to the therapy and all had coronary abnormalities. Conclusion : Most patients with KD ${\geq}7years$ of age have incomplete presentations. They tend to have a higher incidence of initial presentations of unilateral neck mass and coronary artery involvement. In school-aged children, fever and cervical lymphadenitis or suspected neck infection unresponsive to intravenous antibiotics should signal the possibility of KD. A high index of suspicion and prompt treatment is essential in this age group of patients.

• Pediatric Infection and Vaccine
• /
• v.11 no.2
• /
• pp.170-175
• /
• 2004

Purpose : We experienced 7 patients with Kikuchi-Fujimoto disease(KFD) who had presented a prolonged fever and lymphadenopathy. The clinical and the laboratory aspects of the patients were analyzed. Methods : The medical records of the 7 KFD patients, who were confirmed by excisional lymph node biopsy from January 1996 through December 2003, were retrospectively analyzed. Results : The mean age of the children was $11.4{\pm}2.8$ years(ranging from 8 to 15 years). The male to female ratio was 1.3 : 1. The median duration of the fever prior to admission and the total duration of the fever were 12 days(ranging from 5 to 65 days) and 27 days(ranging 9 to 75 days), respectively. One patient had supraclavicular lymphadenopathy, 5 had cercical involvement, and 1 had axillary lymphadenopathy. All the histologic findings of the lymph nodes biopsies showed the characteristic findings consistent with KFD such as paracortical necrosis with karyorrhexis and an increase in the number of phagocytic histiocytes and atypical lymphocytes. As for the laboratory findings, leukopenia($3,800{\pm}700/mm^3$), anemia(hemoglobin, $11.0{\pm}1.2g/dL$), an elevated erythrocyte sedimentation rate($42{\pm}17mm/hr$), and a relatively low C-reactive protein level($1.3{\pm}0.9mg/dL$) were noted. Four patients received conservative therapy with antipyretics, and 3 patients were treated with prednisolone. Conclusion : KFD is a rare disease, yet should be considered in the differential diagnosis for older children with prolonged fever and lymphadenopathy.

• 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.