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Query: UMLS:C0409974 (lupus)
 22,386 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Though irradiation-induced tumours are uncommon they represent a well defined entity. At this Hospital, 14 "irradiation-induced" head and neck tumours were encountered in 11 patients over a 10-year period. The irradiation had been given for tuberculous lymph-adenitis in 6 of the patients, for lupus vulgaris in one, and thyrotoxicosis in another; the other 3 patients had received radiotherapy for malignant tumours. The interval between the treatment and the diagnosis of the tumour disease ranged from 9 to 48 years (mean 32). The induced tumours included 10 squamous cell carcinomas of the hypopharynx (4 tumours), the buccal mucosa (3), the skin (2), and the larynx (1), one poorly differented carcinoma of the parotid gland, 2 thyroid carcinomas and 1 fibrosarcoma of the stenocleidomastoid muscle. Three of the patients had multiple tumours. In view of the risk of cancer--albeit a small one--associated with radiological diagnosis and radiotherapy, these should be performed only on strict indications, especially in young patients.
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PMID:Irradiation-induced tumours of the head and neck. 28 35

This case report describes the aspiration cytologic characteristics of histologically proven acute lupus lymphadenitis. The aspirate contained numerous lymphoid cells and many amorphous, basophilic, hematoxylin-stained bodies dispersed in a granular, necrotic background that lacked polymorphonuclear leukocytes. The lymphadenopathy was diagnosed cytologically as necrotizing lymphadenitis and histologically as acute lupus lymphadenitis.
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PMID:Fine needle aspiration cytology in lupus lymphadenopathy. A case report. 152 36

We report three cases of systemic lupus erythematosus (SLE) associated with necrotizing histiocytic lymphadenitis (Kikuchi's disease) and immunologically proven human parvovirus B19 infection. Simultaneous occurrence of SLE and Kikuchi's disease was a characteristic of the three cases. Kikuchi's disease is an uncommon disease that usually affects young women and is characterized by painless unilateral cervical lymph-node enlargement. T-cell regions of affected lymph nodes are exclusively involved with patchy paracortical necrosis surrounded by a polymorphous cell population of histiocytes and macrophages. However, lymphadenopathy in patients with SLE may be histologically indistinguishable from Kikuchi's necrotizing lymphadenitis. The cause of Kikuchi's disease remains uncertain, although infectious agents have been proposed. A positive IgM-specific anti-human parvovirus B19 antibody test in our three cases suggests that B19 can induce a necrotizing histiocytic lymphadenitis and possibly a clinical SLE flare. High-dose (1 mg/kg/day) and medium-dose (0.5 mg/kg/day) oral prednisone was an effective treatment for constitutional and visceral symptoms of Kikuchi's and SLE diseases.
Lupus 1991 Nov
PMID:Parvovirus B19 infection can induce histiocytic necrotizing lymphadenitis (Kikuchi's disease) associated with systemic lupus erythematosus. 184 62

Thirty-six cases of necrotizing lymphadenitis--including 33 cases of unknown etiology, 1 typhoid lymphadenopathy, and 2 cases of suspicious lupus lymphadenopathy--were clinico-pathologically reviewed and analyzed with immunostaining for s-100 and lysozyme. All cases histologically showed architectural effacement by paracortical lesions composed of nuclear karyorrhexis and mononuclear cell proliferation. Immunohistochemical study revealed proliferation of lysozyme-positive macrophages in the necrotizing areas and an increase in the number of s-100-positive cells in the uninvolved paracortical areas. This observation suggests that necrotizing lymphadenitis may be a common morphologic expression of a T cell-mediated hyperimmune condition induced by diverse etiologies.
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PMID:Necrotizing lymphadenitis--a clinico-pathologic study of 36 cases with immunohistochemical analysis. 188 50

A case of lupus lymphadenitis with frozen section immunohistologic studies is presented. Clinically, the patient had well-documented systemic lupus erythematosus (SLE) when rapid development of generalized lymphadenopathy raised the possibility of a diagnosis of malignant lymphoma. Histologically, the findings of paracortical foci of necrosis and hematoxylin bodies were diagnostic of SLE. Granulocytes were absent. Monoclonal antibodies applied to frozen sections demonstrated two predominant cell populations within and surrounding the paracortical zones of necrosis: OKM1+, Leu-M1+ histiocytes and OKT8+, Leu-4+ T cytotoxic/suppressor cells. In the lymph node not involved by necrosis, lymphoid follicles were composed of polytypic B cells and the interfollicular regions of T cells. Leu-3a+, Leu-4+ T helper/inducer cells outnumbered T cytotoxic/suppressor cells in a 3:1 ratio. Since lupus lymphadenitis may closely resemble histiocytic necrotizing lymphadenitis of Kikuchi and Fujimoto, particularly if hematoxylin bodies are not found, we compared the findings in this case with findings of cases of histiocytic necrotizing lymphadenitis of Kikuchi and Fujimoto reported in the literature. The immunologic findings in both diseases are similar. We conclude that immunologic studies using frozen sections are probably of no help in differentiating between these two disorders when histologic findings are not conclusive.
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PMID:Lupus lymphadenitis: report of a case with immunohistologic studies on frozen sections. 265 95

Twenty-seven cases of an unusual necrotizing lymphadenitis previously described only in Japan are reported as occurring in West Germany (23 cases), Iran (1 case), Italy (1 case), Korea (1 case) and Spain (1 case). The lesion frequently develops in the cervical lymph nodes of young women. It is characterized by infiltration of the cortex and/or paracortex by large collections of proliferating histiocytes and is devoid of granulocytes. Complete or, more often, incomplete necrosis of lymphoid tissue is seen in all cases. In cases with incomplete necrosis, the histiocytes are interspersed with pyknotic cells and nuclear debris. Based on the histological findings, the term "histiocytic necrotizing lymphadenitis without granulocytic infiltration" is proposed. Lesions to be considered in a differential diagnosis are malignant histiocytic neoplasms and necrotizing lymphadenitis with granulocytic infiltration, which is seen in lupus erythematosus and bacterial infections. The aetiology of histiocytic necrotizing lymphadenitis without granulocytic infiltration is still unclear. Some clinical and histological features indicate the possibility of an underlying viral infection.
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PMID:Histiocytic necrotizing lymphadenitis without granulocytic infiltration. 711 35

Kikuchi's lymphadenitis is a self-limiting condition typically affecting young patients. Surgical biopsy is unnecessary if a firm diagnosis can be rendered by fine-needle aspiration cytology (FNAC). The authors report the FNAC findings for 27 cases, including 24 female and 3 male patients aged 12 to 43 years. Histologic sections of FNAC cell blocks and excisional biopsy specimens were available in 26 and 9 cases, respectively, for confirmation of the diagnosis. In the smears, karyorrhectic and granular debris were mixed with two distinctive cell types: (1) phagocytic histiocytes with peripherally placed "crescentic" (sometimes elongated or twisted) nuclei and abundant cytoplasm containing phagocytosed karyorrhectic or eosinophilic granular debris, easily distinguishable from tangible-body macrophages, which possessed central round nuclei, and (2) medium-sized cells possessing eccentrically placed round nuclei, fairly condensed chromatin, and a moderate amount of amphophilic cytoplasm, consistent with plasmacytoid monocytes. Also present were nonphagocytic histiocytes with twisted nuclei and delicate chromatin and immunoblasts that sometimes showed atypical features such as irregular foldings of the nuclei. Neutrophils were sparse or absent. Review of the FNAC findings of 50 lymph nodes involved by various reactive processes, tuberculosis, and lymphoma for comparison showed that although tangible-body macrophages and debris were not uncommon, very few phagocytic histiocytes with crescentic nuclei were observed, in only 2 cases; plasmacytoid monocytes were observed in 4 cases. The constellation of features described above permits diagnosis of Kikuchi's lymphadenitis by FNAC. Because of morphologic similarities between lupus lymphadenitis and Kikuchi's lymphadenitis, however, serologic studies are warranted to exclude systemic lupus erythematosus.
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PMID:Fine-needle aspiration cytologic diagnosis of Kikuchi's lymphadenitis. A report of 27 cases. 752

We conducted a clinicopathologic study of 79 cases of Kikuchi's disease. Our results confirmed that Kikuchi's disease is a distinctive type of necrotizing lymphadenitis that affects primarily the cervical lymph nodes of young adults and has a self-limited clinical course. However, female predominance was not as striking as heretofore reported. A low, but possible, recurrence rate of 3.3% was documented. Extranodal cutaneous involvement occurred in one patient who had a more severe and protracted clinical course. Classification of the histopathologic changes into three histologic types was proposed: proliferative, necrotizing, and xanthomatous types. These three types differed in certain aspects of their clinical features. Immunohistologic analysis revealed that the predominant cells of the lesions were various types of histiocytes, including the enigmatic plasmacytoid monocytes. A variable number of CD8(+) T cells correlating with the duration of the disease was detected. B cells were nearly absent, and only an insignificant number of OPD4(+) T cells was present. Eight cases studied by the flow cytometric DNA analysis all showed a diploid DNA content. Although the histologic changes of Kikuchi's disease were variable, the findings were sufficiently distinctive to permit accurate diagnosis. Malignant lymphoma and especially lupus lymphadenitis can be mistaken for Kikuchi's disease; thus differentiation is crucial.
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PMID:Kikuchi's disease (histiocytic necrotizing lymphadenitis). A clinicopathologic study of 79 cases with an analysis of histologic subtypes, immunohistology, and DNA ploidy. 779 78

Histiocytic necrotizing lymphadenitis or Kikuchi disease is a rare entity; furthermore, its association with systemic lupus erythematosus (SLE) was only described in 11 patients in seven reports in the world literature. As the disease affects young women and manifests as a systemic illness associated with lymphadenopathy (usually cervical), the importance of continued follow-up to see whether it remains a self-limiting process or evolves into systemic lupus erythematosus should be emphasized. We present the clinical and histopathological data of eight patients with Kikuchi disease diagnosed in one tertiary care centre, two of whom evolved into SLE. White blood count was normal in all except the two patients who evolved into SLE; erythrocyte sedimentation rate was elevated in all patients tested. Kikuchi disease could be misdiagnosed as non-Hodgkin's lymphoma or tuberculous lymphadenitis; furthermore, awareness of its association with SLE is emphasized.
Lupus 1994 Oct
PMID:Kikuchi disease and its association with systemic lupus erythematosus. 784 95

Necrotizing lymphadenitis dominated by individual cell necrosis with tingible body macrophages and karyorrhectic nuclear debris is an unusual appearance in smears from fine-needle biopsies (FNB) of lymph nodes (Greenberg et al., Diagn Cytopathol 1993; 9:443-447). These features together with a polymorphous population of lymphocytes, absent epithelioid histiocytes and neutrophils, suggest a possible diagnosis of either histiocytic necrotizing lymphadenitis (HNL) (syn. Kikuchi's Disease) or systemic lupus erythematosus (SLE). These were the cytologic features found in a FNB of a cervical lymph node in a 43-year-old female, treated for a mixed connective tissue disease. A presumptive diagnosis of an acute lupus lymphadenitis was made, based on the above features, and was subsequently confirmed by the presence of raised antinuclear antibodies as well as resolution of the lymphadenopathy on high dose steroids.
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PMID:Role of fine-needle biopsy in an atypical case of lupus lymphadenopathy. 818 98


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