Clinicopathologic spectrum of necrotizing lymphadenitis

Area of Science:

• Pathology
• Immunology
• Infectious Diseases

Background:

• Necrotizing lymphadenitis encompasses diverse conditions causing lymph node inflammation and necrosis.
• Common causes include Kikuchi-Fujimoto disease, Epstein-Barr viral infection, and systemic lupus erythematosus.

Purpose of the Study:

• To investigate lymph node morphology in necrotizing lymphadenitis.
• To correlate morphological findings with specific etiological conditions.

Main Methods:

• Retrospective review of 58 necrotizing lymphadenitis cases.
• Categorization into acute EBV, lupus, and Kikuchi's lymphadenitis subtypes.
• Analysis of morphological features: vascular proliferation, periadenitis, foamy macrophages, neutrophil, and plasma cell infiltrate.

Main Results:

• Kikuchi's lymphadenitis accounted for 62.2% of cases.
• Female preponderance observed in lupus (78%) and Kikuchi's (62%) lymphadenitis.
• Plasma cell infiltration and vascular proliferation significantly associated with lupus lymphadenitis.
• Lupus lymphadenitis required long-term therapy, while Kikuchi's and EBV were generally self-limiting.

Conclusions:

• Kikuchi's lymphadenitis is the most frequent cause, followed by lupus and EBV.
• Etiological classification is crucial due to differing prognoses and treatments.
• Morphological features, particularly plasma cell infiltrate and vascular proliferation, aid in predicting lupus lymphadenitis etiology.