Objective: To study the clinical manifestation and pathological features of histiocytic necrotizing lymphadenitis (Kikuchi's disease, KD).
Methods: 52 patients with KD were collected to analyze the clinical manifestation, pathological features of biopsy lymph nodes, diagnosis and treatment.
Results: 41 cases (79%) were female of the 52 patients. The main clinical features included persistent fever (100%), single (23%)/multi (77%)-lymphadenopathy (always in cervical region), pleomorphism erythra (35%), neutropenia (76%), elevated erythrocyte sedimentation rate (100%), insensitivity to antibiotics (100%) and sensitivity to small dosage glucocorticoid (81%). 26 cases (50%) had elevated aspartate aminotransferase and/or alanine aminotransferase, but only 7 cases (13%) had upper respiratory tract symptom like influenza. Pathological features included distinctive necrosis, loss of lymph node structure, infiltration with histiocytes and lymphocytes, absence of neutrophils. Immunohistochemical stainings showed CD(68) positive for histiocytes and CD(3), CD(45) RO positive for T lymphocytes.
Conclusion: Diagnosis of KD relies on the pathological examination and immunohistochemical staining.