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- Causes of necrotic features in fine-needle aspirates from cervical lymph nodes
- Young Jin Seo, Hyeongchan Shin, Hye Won Lee, Hye Ra Jung
- J Pathol Transl Med. 2021;55(1):60-67. Published online November 27, 2020
- DOI: https://doi.org/10.4132/jptm.2020.09.28
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- 3 Web of Science
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Abstract
PDF - Background
Lymph node fine-needle aspiration (LN FNA) cytology indicates necrosis in various diseases. Dominant necrotic features make the diagnosis of underlying conditions very difficult.
Methods
We retrospectively reviewed 460 patients who underwent cervical LN aspiration cytology that revealed necrotic findings at Keimyung University Dongsan Hospital in Daegu, Korea, from 2003–2017. Each specimen was evaluated and analyzed in association with the clinical findings, biopsy findings, and/or other ancillary tests, including acid-fast bacilli staining and molecular testing for Mycobacterium tuberculosis.
Results
When necrotic features were noted upon cervical LN FNA cytology, the most common pathologic LN FNA category was necrosis alone (31.5%). The second most common category was granulomatous inflammation (31.3%), followed by Kikuchi disease (20.0%) and malignant neoplasm (8.7%). In cases where the cervical LN FNA revealed necrosis alone, the most common final diagnosis was tuberculosis. In young patients, Kikuchi disease should be considered as one cervical LN FNA category, while metastatic carcinoma should be suspected in older patients.
Conclusions
Even when necrosis alone is observed in LN FNA cytology, it is important to determine the cause through further evaluation. -
Citations
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- The Clinicopathologic Analysis of Kikuchi's Lymphadenitis.
- Jung Woo Choi, Ji Hye Lee, Ju Han Lee, Yang Seok Chae, Insun Kim
- Korean J Pathol. 2004;38(5):289-294.
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- 20 Download
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Abstract
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- 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.
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