아급성 림프절염의 임상·병리학적 분석 = The Clinicopathologic Analysis of Kikuchi's Lymphadenitis

다국어 초록 (Multilingual Abstract)

Background : Kikuchi's disease has been known as a self-limiting lymphadenitis mostly affecting the cervical lymph nodes of young women. Methods : We retrospectively reviewed the clinical data of 77 cases of Kikuchi's lymphadenitis from 1996 to 2003 at Korea University Medical Center. Results : Histologically, 69 available cases were classified into three types: proliferative (60.8%), necrotizing (33.3%), and xanthomatous type (5.7%). These three types differed in terms of their clinical features, showing tenderness most predominantly in the necrotizing type. In spite of the insufficient numbers of cases, the data on the duration of the disease well correlated with the possible progression of the three histologic types (Kikuch's disease begins as proliferative type, then progress into necrotizing type and finally resolves into xanthomatous type). During the ten-month period of the mean follow-up, the recurrence rate was 7.0%. Three and two patients developed into pulmonary tuberculosis and systemic lupus erythematosus, respectively, but there were no prognostic differences among the three types. Conclusions : Our results confirmed that Kikuchi's lymphadenitis is a self-limiting necrotizing lymphadenitis with a low rate of recurrence. Here, we suggest that the classification of histologic types have some meanings because of their differences in certain clinical aspects and possible sequential disease progression.

참고문헌 (Reference)

• 1 "Virusinfection in patients with histiocytic necrotizing lymphadenitis inTaiwan detection of Epstein virus type 1 human T-cell lymphotropicvirus, and parvovirus B19." 113 : 774-781, 2000
• 2 "Two cases of histiocyticnecrotizing lymphadenitis(Kikuchi-Fujimoto’s disease) followingdiffuse large B-cell lymphoma." 31 : 1328-1331, 2000
• 3 "Proliferating cells in histiocyticnecrotizing lymphadenitis," 97-100,
• 4 "Pathologic analyses of non-overtnecrotizing type Kikuchi and Fujimoto’s disease" 43 : 635-645, 1993
• 5 "Necrotizing lymphadenitis: a studyof 30 cases." 7 : 115-23, 1983
• 6 "Necrotizing lymphadenitis without granulocyticinfiltration" 1252-7, jclinpathol1985;38
• 7 "Kikuchi’s histiocytic necrotizing lymphadenitis:an analysis of 108 cases with emphasis on differential diagnosis" 5 : 329-345, 1988
• 8 "Kikuchi’s disease (Histiocytic Necrotizing Lymphadenitis).A clinicopathologic study of 79 cases with an analysisof histologic subtypesimmunohistology, and DNA ploidy." 19 : 798-809, 1995
• 9 "Kikuchi-Fujimoto’s disease: aneasily misdiagnosed clinical entity." 125 : 651-653, 2001
• 10 "Kikuchi-Fujimotodisease of the neck" 11-5,
• 11 "Kikuchi-Fujimoto diseasemimicking malignant lymphoma." 14 : 514-523, 1990
• 12 "Kikuchi-Fujimoto disease: a reportof two cases and an overview." 108 : 1001-1004, 1994
• 13 "Kaposi’s sarcoma-associated herpesvirus in Kikuchi’s disease" 29 : 1091-1096, 1998
• 14 "Immunohistological study of skin involvement in Kikuchi’sdisease" 62 : 263-269, 1992
• 15 "Human herpesvirus-6genomes in histiocytic necrotizing lymphadenitis(Kikuchi’s disease) and other forms of lymphadenitis" 99 : 609-614, 1993
• 16 "Histiocytic necrotizinglymphadenitis without granulocytic infiltration" 257-71,
• 17 "Fatal Kikuchi-Fujimoto disease: the lupus connection." 82 : 186-188, 2003
• 18 "Cutaneous manifestation of Kikuchi’s histiocytic necrotizinglymphadenitis" 872-6, amjsurgpathol1990;14
• 19 "Clinical characteristics ofsubacute necrotizing lymphadenitis." 41 : 640-646, 1998
• 20 "Cervical subacute necrotizinglymphadenitis." 30 : 920-927, 1972
• 21 "Aninvestigation of the viral pathogenesis of Kikuchi-Fujimoto disease, Lack of evidence for Epstein-Barr virus or human herpesvirus type6 as the causative agents" 118 : 134-140, 1994
• 22 "An ultrastructural study ofsubacute necrotizing lymphadenitis." 107 : 292-299, 1982
• 23 "A pseudo-tumoralform of Kikuchi’s disease in children: a case report and review ofthe literature." 45 : 1-6, 1998
• 24 "A morphologicanalysis of 75 cases with special reference to unusual features" 219-31, amjsurgpathol1994;18
• 25 "A clinicopathological study of nine cases" 22-8, pathology1986;18