Kikuchi's disease of lymph nodes

Objective: To observe and document the clinical features, mode of presentation, histopathological and immunohistochemical features of Kikuchi's disease. Results: Kikuchi's disease was diagnosed in 31 cases (1.9%) out of 5762 lymph node biopsies received. There were 10 male and 21 female patients. Ten patients were aged between 21 and 25 years (33%). Eight (25.8%) patients were from pediatric age group. Thirty patients (96.4%) presented with cervical lymphadenopathy. Thirteen (41.9%) lymph nodes showed fragmentation, while 8 (25.8%) revealed periondal spill. Seventeen cases (54.7%) showed more than 50% necrosis. Zonation was seen in 13 (41.9%) cases. Immunohistochemistry showed majority of cells to be histiocytes and T-lymphocytes. Eight cases were followed-up, all of which showed regression of symptoms over 4-8 months. Conclusion: Kikuchi's disease is an uncommon cause of cervical lymphadenopathy in young females. Necrotic areas, karyorrhexis, zonation, absence of neutronphils and predominance of histocytes with many plasmacytoid monocytes are features that aid in diagnosis. Immunohistochemistry can be used to differentiate it from malignant lymphoma. It is important for clinicians and pathologists to be aware of this entity as it is a benign disorder with a self-limiting course. (author)