组织细胞坏死性淋巴结炎临床分析

目的分析组织细胞坏死性淋巴结炎的临床资料。方法回顾性分析经病理证实的43例组织细胞坏死性淋巴结炎患者的临床特点和治疗过程、预后。结果 43例患者的男女发病率为1：1.15,所有患者均有颈部淋巴结肿大,77%患者伴有发热。20例行糖皮质激素治疗,13例未予药物干预,8例予消炎、止痛等对症治疗,2例手术清扫颈部肿大淋巴结。5例并发感染或自身免疫性疾病,其中2例死亡。随访22例中有5例复发,再次激素治疗有效。结论组织细胞坏死性淋巴结炎的临床表现、实验室和影像检查缺乏特异性,淋巴结活检病理检查可明确诊断。可并发自身免疫性疾病,有必要定期监测免疫功能和随访。     

颈部亚急性坏死性淋巴结炎所占表浅淋巴结的比率及临床表现

亚急性坏死性淋巴结炎 ,是主诉全身各部表浅淋巴结肿胀 ,伴有高热和疼痛 ,经过 2～ 3个月自然治愈 ,预后良好的疾患。文章重点对颈部亚急性坏死性淋巴结炎临床表现及治疗进行了统计观察。1987年 4月～ 1997年 3月 10年内 ,全身各处表浅淋巴结活检 6 2 9例 ,其中颈部淋巴结活检 4 2 1例(72 % ) ,经病理确诊亚急性坏死性淋巴结炎 54例 ,占全组的 9% ,占颈部淋巴结 13%。男 18例 ,女 36例 ,10～ 30多岁青年好发 ,占全组的 87% ,年龄最小 6岁 ,最大 4 5岁 ,平均年龄男 19岁 ,女 2 5岁 ,每年 10月～ 3月多发。记录临床症状和经过 4 0例 ,发热 34…     

组织细胞坏死性淋巴结炎2例

组织细胞坏死性淋巴结炎（histocyticBecrotizing]ymphadenitis,HNL）是一种少见的良性自限性疾病。1972年首先由日本学者Kikuehi和Fujimoto等报道,又称菊池病（Kikuchidisease）或Kikuehi—Fujimoto病（KFD）。该病以发热、颈部淋巴结肿大为主要临床表现,可累及多系统多器官,缺乏特异性,临床上容易误诊为淋巴瘤或淋巴结结核等,确诊主要依据淋巴结病理学检查。现将我院2007年收治的2例HNL的临床资料进行分析,现报道如下。     

颈部组织细胞坏死性淋巴结炎的诊断治疗分析

组织细胞坏死性淋巴结炎(histiocytic necrotizing lymphadenitis,HNL)又称为Kikuchi-Fujimoto病(KikuchiFujimoto disease,KFD),或Kikuchi病,是多见于年轻女性的一种良性自限性疾病.首诊的临床表现多为颈部淋巴结的肿大,半数以上的患者同时伴有发热和外周血淋巴细胞的减少[1].病程在数周至6个月不等,超过6个月的患者很少.该病在世界各地均有零散病例报道,以东亚人群为主.本文报道13例HNL患者诊断治疗资料.     

Kikuchi氏病3例报道及文献回顾

Kikuchi氏病亦称组织细胞坏死性淋巴结炎，首例于1972年在日本被报道，1977年后陆续出现了对此病的报道，但例数很少。该病大多发生在30岁以下的青年女性，其主要临床表现为颈部淋巴结肿大、发热和疲劳，部分病人会出现斑丘疹等皮肤体征，易被误诊为恶性淋巴瘤或系统性红斑狼疮。对该病缺乏有效的实验室检测手段，病人可能有轻度的白细胞减少，血况加快及C一反应蛋白含量增高等，不具备特殊性。确诊该病唯一可靠的手段是肿人淋巴结活检，镜厂见淋巴结到皮质区出现坏死灶，坏死灶内存在核碎裂，无多形核，坏死处周围有巨噬细胞包绕，在皮质…     

原发性颈淋巴结结核的临床特征与治疗

目的：探讨原发性颈部淋巴结结核的临床特征和治疗方法。方法：回顾性分析32例原发性颈部淋巴结结核患者的临床资料。32例患者中29例活检前行CT检查,4例行细针穿刺针吸活检确诊,28例行手术病理检查确诊。27例行肿块全部切除或区域性颈部淋巴结清扫术,术后全身抗结核治疗6个月;5例确诊后行常规抗结核治疗1年。结果：CT显示肿块呈均匀或不均匀强化,部分肿块呈融合现象。全部病例治疗后均行随访,手术患者术后切口均Ⅰ期愈合,1例术后抗结核治疗3个月肿块增大,再次手术确诊为颈部淋巴结结核并发鼻咽癌颈部淋巴结转移,转肿瘤科治疗,其余31例患者均无颈部淋巴结结核复发和其他结核病表现。结论：原发性颈部淋巴结结核临床特征发生改变,颈部肿块为首发症状,多数位于颈后三角区。CT检查有助于本病的诊断和鉴别诊断。全身抗结核药物和手术切除淋巴结的联合应用能有效地治疗原发性颈部淋巴结结核。原发性颈部淋巴结结核的治疗应以手术为主,手术治疗能缩短治疗时间、减少药物用量及不良反应,防止冷脓肿及窦道形成。     

结核性颈淋巴结炎的手术治疗（附6例报告）

报告手术治疗６例结核性颈淋巴结炎，均经病理学检查确诊，结合术后化疗治愈。认为：手术结合化疗是治疗结核性颈淋巴结炎安全有效的手段，对经全面检查未发现原发病灶的颈部单个肿块，应考虑结核可能性，主张及早手术切除活检，避免长期误诊。     

结核性颈淋巴结炎的手术治疗

报告手术治疗６例结核性颈淋巴结炎，均经病理学检查确诊，结合术后化疗治愈。认为：手术结合化疗是治疗结核性颈淋巴结炎安全有效的手段。对经全面检查未发现原发病杜的颈部单个肿块，应考虑结核可能性，主张及早手术切除活检，避免长期误诊。     

组织细胞坏死性淋巴结炎10例临床分析

组织细胞坏死性淋巴结炎(HNL)是一种发生于淋巴结的良性、自限性疾病,好发于青少年,较多见于女性,亚洲发病率较高,近年发病率有上升趋势。由于该病的临床表现缺乏特异性,加之人们对HNL认识不足,临床上误诊率极高,约40%误诊为恶性淋巴瘤,我院于1987年1月~2004年4月共收治10例,现报告如下。1临床资料1.1一般资料选择1987年1月~2004年4月在我院经淋巴结活检确诊、临床资料完整的HNL10例,其中男3例,女7例;年龄17~36岁,平均27.4岁;全部病例均有发热,体温38~40℃,热程10~25d,热型不规则6例,弛张型4例,伴畏寒、寒颤7例,10例均有浅表淋巴结肿大,…     

颈淋巴结结核临床分析

目的探讨颈淋巴结结核的临床特点、诊断及治疗方法。方法回顾性分析2004年10月～2011年5月我院收治的83例颈淋巴结结核患者的临床资料。结果 83例颈淋巴结结核患者,女性多见;肿块位于颈侧中上部30例(36.1%),锁骨上窝32例(38.6%);合并肺结核的12例(14.5%);31例行颈部CT扫描,21例增强扫描表现为肿物环形强化;11例行淋巴结针吸活检,8例确诊,其余3例经淋巴结活检确诊;3例抗结核治疗无效。结论颈淋巴结结核以颈侧部和锁骨上窝肿块为主要表现,部分合并肺结核;颈部增强CT扫描有重要的诊断价值;针吸活检不能确诊的应尽早手术活检;多数患者只需行抗结核治疗,无效者需行手术治疗。     

Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease) diagnosed by fine needle aspiration biopsy.

A case of histiocytic necrotizing lymphadenitis involving a right submandibular lymph node is described in a 14-year-old Caucasian boy. The diagnosis was established on initial assessment by fine needle aspiration biopsy. Excisional biopsy, performed because the lymph node enlargement failed to regress, confirmed the cytological findings.     

Kikuchi-Fujimoto's syndrome masquerading as tuberculosis.

We report a case of a 27-year-old Asian man presenting with the typical features of tuberculous cervical lymphadenitis who was commenced on anti-tuberculous therapy on the strength of the clinical presentation. Histological examination of an excised cervical lymph node however, revealed the diagnosis of Kikuchi's syndrome; a histiocytic necrotizing lymphadenitis which is usually self-limiting.     

Kikuchi-Fujimoto disease mimicking thyroid metastasis

INTRODUCTION: Kikuchi-Fujimoto lymphadenopathy is a subacute necrotizing lymphadenopathy of unknown origin. It usually affects cervical lymph nodes. Lymph node biopsy is needed for establishing the diagnosis. This disease must be considered as a possible cause of lymphadenopathy of unknown origin, certainly if classical clinical features lead to diagnostic confusion. OBSERVATION: A 41-year-old female presented a thyroid cancer treated by thyroidectomy associated with administration of I131. She also presented a right cervical metastasis treated by surgery. She had a cervical right cervical lymphadenopathy, hypermetabolic on the FDG scan, treated by a modified neck dissection. Microscopy of the surgical specimen showed necroziting lymphadenitis. DISCUSSION: Kikuchi-Fujimoto lymphadenopathy is a subacute necroziting lymphadenopathy of unknown origin, involved more commonly cervical lymph nodes unilaterally. It is more common in Asia, predominantly in young women. This lesion has been reported in patients of virtually any age or gender. No specific biological findings have been described. Lymph node biopsy is needed for establishing the diagnosis. The spontaneous course is usually favorable but one fatal case has been reported.     

Pediatric Kikuchi-Fujimoto disease masquerading as a submandibular gland tumor

Kikuchi-Fujimoto disease, also known as histiocytic necrotizing lymphadenitis, is a rare disorder that typically affects the cervical lymph nodes. The disease usually occurs in women in their late 20s or early 30s. Reports in the pediatric literature are sparse. Most authors consider Kikuchi-Fujimoto disease as a self-limiting disorder that requires no specific management but long-term follow-up. The clinical features of Kikuchi-Fujimoto disease are easily confused with other less-benign conditions. Thus, an early biopsy is instrumental in making definite diagnosis and preventing unnecessary investigations. We describe a case of Kikuchi-Fujimoto disease in an 8-year-old boy which presenting as a submandibular gland tumor. The case illustrates the clinical features of this unusual condition and emphasizes the potential confusion with other diagnoses.     

Kikuchi-Fujimoto disease: a report of 3 cases

Cervical lymphadenopathy has many underlying etiologies. One of its rare causes is Kikuchi-Fujimoto disease (Kikuchi's disease, histiocytic necrotizing lymphadenitis). We discovered such a cause in a 37-year-old woman who had presented with malaise, night sweats, and weight loss in addition to cervical lymphadenopathy. We based our diagnosis on excisional lymph node biopsy. We also review 2 other cases of Kikuchi's disease that were diagnosed by others at our institution. Clinically and histologically, Kikuchi's disease is very similar to lymphoma, and distinguishing the two is difficult. However, despite the fact that Kikuchi's disease is benign, an accurate diagnosis is important because misdiagnosis might lead to unnecessary surgery and/or chemotherapy.     

Kikuchi-Fujimoto disease: report of two cases

Kikuchi-Fujimoto disease, described for the first time in 1972, is an unusual diagnosis that is characterized by lymph node enlargement and fever. Cervical lymph nodes are affected so often that ENT specialists should be aware of this entity during differential diagnosis. The diagnosis was done by histological features, necrotizing lymphadenitis. The disease is self-limited and it has good prognosis. We have reviewed two cases in our hospital. We report an aseptic meningoencephalitis as a rare complication.     

Suppurative cervical lymphadenitis in adult: An analysis of predictors for surgical drainage

ObjectiveLymphadenitis can be treated successfully by empirical antibiotic therapy. However, inflamed lymph nodes can progress into an abscess with local and/or systemic reaction, which requires more complex treatment strategies. The study aim to analyze possible predictors for abscess formation within inflamed nodes that require surgical drainage.Materials and MethodsWe retrospectively enrolled 241 patients with acute or sub-acute cervical lymphadenitis. Demographic including, lymph node characteristics, management, and final diagnosis were recorded. Predictors for abscess formation within the lymph node that required surgical drainage were evaluated using univariate and multivariate analysis. Patient and lymph node characteristics that differentiated suppurative cervical lymphadenitis (SCL) from other lymphadenitis were also analyzed.ResultsThere were 41 cases of SCL, 173 cases of uncomplicated cervical lymphadenitis, and 27 cases of tuberculous cervical lymphadenitis (TBLN). Abscess was surgically drained in 39 patients, while 2 patients received a needle aspiration. In 9 patients, SCL complications included cellulitis of the neck soft tissue, supraglottic swelling, internal jugular vein thrombosis, and sepsis. Two patients were diagnosed with melioidosis and actinomycosis after drainage. Multivariate analysis showed that an immunocompromised host, male sex, and receiving prior inadequate treatment were predictors for surgical drainage. TBLN patients had similar manifestations as SCL patients. However, affected nodes in SCL patients were singular, painful, and showed fluctuation.ConclusionsFollowing SCL diagnosis, abscess drainage and appropriate antibiotic treatment should be considered. Aspiration or surgical drainage can be effective in certain patients. Pathogen isolation and tissue biopsy should be performed to ensure accurate diagnosis and antibiotic selection. In addition, TBLN and melioidosis should be considered, especially in endemic areas.     

Kikuchi — Fujimoto disease

Kikuchi — fujimoto disease also known as histiocytic necrotizing lymphadenitis is an idiopathic benign self limiting condition with a favourable outcome, usually affecting young women. The following cases have burn reported for clinical interest and for the rarity of the reports about this condition in ENT literature. In our series, we had 2 female patients aged 18 years and 25 years respectively and a male patient aged 45 years, presenting with fever, bilateral tender multiple cervical adenopathy including posterior triangle nodes not responding to routine antibiotics and anti-inflammatory drug treatment. ENT findings were within normal limits. Routine clinical investigations were within normal limits except for the raised ESR. Biopsy from one of the enlarged glands revealed necrotizing lymphadenitis. All the patients subsequently showed significant improvement locally in the neck and systemically without any further active treatment.