Histiocytic necrotizing lymphadenitis (Kikuchi's disease): clinicopathologic characteristics of 23 cases and literature review.

Kikuchi's disease or histiocytic necrotizing lymphadenitis is a self limiting disorder which usually affects young women and manifests clinically by cervical lymphadenopathy with or without fever. Though the disease has been described since 1972, many clinicians and pathologists are unaware of its existence. We therefore reviewed 23 cases of Kikuchi's disease in Songklanagarind Hospital from 1987 to 1996. Clinical data, histopathology including immunostaining were presented together with brief literature review. We found 18 women and 5 men with the age range 9-57 years. The sites of nodal enlargement were cervical in 17, axillary in 3 and unknown in 3 cases. Typical histologic features namely patchy paracortical lymphohistiocytic aggregates with variable karyorrhexis and absence of granulocytic infiltration were seen. Immunostaining confirmed that the principle cells were histiocytes and T-lymphocytes. Importance in the recognition of the entity was emphasized for it may be mistaken for other infective lymphadenitis or lymphoma.