48,584
edits
Difference between revisions of "Lymph node pathology"
Jump to navigation
Jump to search
→Kikuchi disease: expand
(more) |
(→Kikuchi disease: expand) |
||
| Line 3: | Line 3: | ||
==Kikuchi disease== | ==Kikuchi disease== | ||
===General=== | ===General=== | ||
*AKA ''histiocytic necrotising lymphadenitis''.<ref name="pmid15570824">{{cite journal |author=Kaushik V, Malik TH, Bishop PW, Jones PH |title=Histiocytic necrotising lymphadenitis (Kikuchi's disease): a rare cause of cervical lymphadenopathy |journal=Surgeon |volume=2 |issue=3 |pages=179–82 |year=2004 |month=June |pmid=15570824 |doi= |url=}}</ref> | *AKA ''histiocytic necrotising lymphadenitis'' (HNL).<ref name="pmid15570824">{{cite journal |author=Kaushik V, Malik TH, Bishop PW, Jones PH |title=Histiocytic necrotising lymphadenitis (Kikuchi's disease): a rare cause of cervical lymphadenopathy |journal=Surgeon |volume=2 |issue=3 |pages=179–82 |year=2004 |month=June |pmid=15570824 |doi= |url=}}</ref> | ||
*Rare disease that may mimic cancer, esp. lymphoma. | *Rare disease that may mimic cancer, esp. lymphoma. | ||
*Treatment: | **May cause fever & systemic symptoms.<ref name=pmid20121621>{{cite journal |author=Hutchinson CB, Wang E |title=Kikuchi-Fujimoto disease |journal=Arch. Pathol. Lab. Med. |volume=134 |issue=2 |pages=289–93 |year=2010 |month=February |pmid=20121621 |doi= |url=}}</ref> | ||
Epidemiology:<ref name=pmid20121621/> | |||
*Usually <40 years old. | |||
*Asian. | |||
*Female:Male = 3:1.<ref>URL: [http://emedicine.medscape.com/article/210752-overview http://emedicine.medscape.com/article/210752-overview]. Accessed on: 3 June 2010.</ref> | |||
Treatment: | |||
*Usually self-limited.<ref name=pmid20121621/> | |||
*Oral corticosteroids. | |||
DDx: | |||
*Non-Hodgkin lymphoma. | |||
*Systemic lupus erythematosus. | |||
===Micrograph=== | ===Micrograph=== | ||
Features:<ref>URL: [http://www.ispub.com/journal/the_internet_journal_of_head_and_neck_surgery/volume_1_number_1_30/article_printable/kikuchi_s_lymphadenitis_in_a_young_male.html http://www.ispub.com/journal/the_internet_journal_of_head_and_neck_surgery/volume_1_number_1_30/article_printable/kikuchi_s_lymphadenitis_in_a_young_male.html]. Accessed on: 1 June 2010.</ref> | Features (the three main features - just as the name suggests):<ref>URL: [http://www.ispub.com/journal/the_internet_journal_of_head_and_neck_surgery/volume_1_number_1_30/article_printable/kikuchi_s_lymphadenitis_in_a_young_male.html http://www.ispub.com/journal/the_internet_journal_of_head_and_neck_surgery/volume_1_number_1_30/article_printable/kikuchi_s_lymphadenitis_in_a_young_male.html]. Accessed on: 1 June 2010.</ref> | ||
*Necrosis. | *Histiocytes. | ||
* | *Necrosis (due to apoptosis) - paracortical areas.<ref name=pmid20121621/> | ||
*Lymphocytes (CD8 +ve). | |||
*Plasmacytoid dendritic cells. | |||
Negatives: | |||
*No PMNs. | |||
Notes: | |||
*Dendritic cell - vaguely resembles a macrophage:<ref>URL: [http://www.healthsystem.virginia.edu/internet/hematology/hessedd/benignhematologicdisorders/normal-hematopoietic-cells/dendritic-cell.cfm?drid=214 http://www.healthsystem.virginia.edu/internet/hematology/hessedd/benignhematologicdisorders/normal-hematopoietic-cells/dendritic-cell.cfm?drid=214]. Accessed on: 3 June 2010.</ref> | |||
**Long membrane projections - '''key feature'''. | |||
**Abundant blue-grey cytoplasm, +/- ground-glass appearance. | |||
**Nucleus: small, ovoid, usu. single nucleolous. | |||
Images: | |||
*[http://www.surgicalpathologyatlas.com/glfusion/mediagallery/media.php?s=20080802171644281 Kikuchi disease (surgicalpathologyatlas.com)]. | |||
*[http://www.healthsystem.virginia.edu/internet/hematology/hessedd/benignhematologicdisorders/normal-hematopoietic-cells/dendritic-cell.cfm?drid=214 Dendritic cell (virginia.edu)]. | |||
===IHC=== | ===IHC=== | ||
*CD68 +ve. | *CD68 +ve. | ||
*CD20, CD3, and CD30 - mixed. | *CD8 +ve. | ||
*CD4, CD20, CD3, and CD30 - mixed. | |||
**Done to excluded lymphoma; should show a mixed population of lymphocytes. | **Done to excluded lymphoma; should show a mixed population of lymphocytes. | ||