Korean J Pediatr.  2008 Nov;51(11):1198-1204. 10.3345/kjp.2008.51.11.1198.

Analysis of disease mechanism of subacute necrotizing lymphadenitis in children

• Kim HJ
• Yeom JS
• Park JS
• Park ES
• Seo JH
• Lim JY
• Park CH
• Woo HO
• Cho JM
• Lee JH
• Youn HS

• KMID: 2280244
• DOI: http://doi.org/10.3345/kjp.2008.51.11.1198

Abstract

PURPOSE: The cause of subacute necrotizing lymphadenitis, a rare disease in children, has not been completely clarified. This study was aimed to investigate the disease mechanism by examining clinical, radiologic, and immunohistochemical findings in children diagnosed with subacute necrotizing lymphadenitis after an excisional biopsy.
METHODS
We examined 19 lymph node tissue specimens from 17 children diagnosed with subacute necrotizing lymphadenitis at Gyeongsang National University Hospital from March, 1998 to July, 2006. A retrospective survey of the medical records was performed. CT findings were analyzed. Immunohistochemical staining was done on tissues obtained by excisional biopsy from all patients.
RESULTS
The patient's age ranged from 5 to 19 years (average age :11.8 years). The main symptoms included a neck mass (17/19), pain in the mass (6/17), and fever (12/19). The palpable lymph nodes were mostly cervical in location; the maximum diameter, which was measured radiologically, was less than 3 cm in all 10 cases. The masses were pathologically divided into proliferative, necrotic, and xanthomatous types. With immunohistochemical staining the masses were divided into lesion (L), perilesion (PL), and necrosis (N). The CD8 staining was stronger than the CD4 staining for all regions in three types. The CD4 staining intensity was mainly increased in the perilesion, and CD8 was mainly increased in the lesion.
CONCLUSION
We compared the radiologic findings, clinical symptoms, and pathology to help understand the cause of disease in patients with subacute necrotizing lymphadenitis.

Keyword

Subacute necrotizing lymphadenitis; Excisional biopsy; Immunohistochemistry

MeSH Terms

Biopsy
Child
Fever
Humans
Immunohistochemistry
Lymph Nodes
Lymphadenitis
Medical Records
Neck
Necrosis
Rare Diseases
Retrospective Studies