Kikuchi's histiocytic necrotizing lymphadenitis: an analysis of 108 cases with emphasis on differential diagnosis.
Kikuchi's histiocytic necrotizing lymphadenitis: an analysis of 108 cases with emphasis on differential diagnosis.
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DOI：
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发表时间：
1988-11
影响因子：
2.3
通讯作者：
R. Dorfman;G. Berry
中科院分区：
文献类型：
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作者：
R. Dorfman;G. Berry
菊池坏死性淋巴结炎现已在世界许多地区被认为是一种明确的临床病理学实体，特别好发于年轻女性的颈部淋巴结。淋巴结的形态特征是独特的，应该使病理学家能够自信地做出诊断。尽管如此，对 15 年期间遇到的 108 例病例的分析强调了许多病理学家在识别这种疾病方面的困难，特别是在将其与恶性淋巴瘤区分开来。尽管在绝大多数病例中，淋巴结肿大和其他症状会自行消退，但我们的两名患者最初被认为患有菊池氏病，后来发展为系统性红斑狼疮。这引起了人们对菊池氏病可能反映了一种自限性 SLE 样自身免疫性疾病（SLE 的“forme fruste”）的考虑，可能是由病毒感染的转化淋巴细胞引起的。此外，此类观察结果表明，菊池氏病患者应接受观察数年，以确保他们没有发展为系统性红斑狼疮的风险。
Kikuchi's necrotizing lymphadenitis has now become recognized in many parts of the world as a well-defined clinicopathologic entity with a remarkable predilection for cervical lymph nodes of young women. The morphologic features encountered in lymph nodes are distinctive and should enable pathologists to establish the diagnosis with confidence. Nonetheless, this analysis of 108 cases, encountered over a 15-year period, has emphasized the difficulty that many pathologists have in recognizing this disorder, and in particular, in distinguishing it from malignant lymphoma. Although in the vast majority of cases, lymphadenopathy and other symptomatology resolves spontaneously, two of our patients, thought initially to have Kikuchi's disease, developed systemic lupus erythematosus. This raises consideration for the proposal that Kikuchi's disease may reflect a self-limited SLE-like auto-immune condition (a "forme fruste" of SLE), perhaps induced by virus-infected transformed lymphocytes. Moreover, such observations indicate that patients with Kikuchi's disease should be kept under observation for several years to ensure that they are not at risk for the development of systemic lupus erythematosus.