Korean Journal of Pediatrics 2008;51(11):1198-1204.
Published online November 15, 2008.
Analysis of disease mechanism of subacute necrotizing lymphadenitis in children
Hyun Jung Kim1, Jung Suk Yeom1, Ji Suk Park1, Eun Sil Park1, Ji Hyun Seo1, Jae Young Lim1, Chan Hoo Park1, Hyang Ok Woo1, Jae Min Cho2, Jeong Hee Lee3, Hee Shang Youn1
1Departments of Pediatrics, Gyeongsang National University College of Medicine, Jinju, Korea
2Departments of Radiology, Gyeongsang National University College of Medicine, Jinju, Korea
3Departments of Pathology, Gyeongsang National University College of Medicine, Jinju, Korea
소아 아급성 괴사성 림프절염의 임상적, 방사선학적, 면역조직화학적 소견
김현정1, 염정숙1, 박지숙1, 박은실1, 서지현1, 임재영1, 박찬후1, 우향옥1, 조재민2, 이정희3, 윤희상1
1경상대학교 의과대학 소아과학교실
2경상대학교 의과대학 영상의학과교실
3경상대학교 의과대학 병리학교실
Correspondence: 
Jae Young Lim, Email: pedneu@gnu.ac.kr
Abstract
Purpose
: The cause of subacute necrotizing lymphadenitis, a rare disease in children, has not been completely clarified. This study was aimed to investigate the disease mechanism by examining clinical, radiologic, and immunohistochemical findings in children diagnosed with subacute necrotizing lymphadenitis after an excisional biopsy.
Methods
: We examined 19 lymph node tissue specimens from 17 children diagnosed with subacute necrotizing lymphadenitis at Gyeongsang National University Hospital from March, 1998 to July, 2006. A retrospective survey of the medical records was performed. CT findings were analyzed. Immunohistochemical staining was done on tissues obtained by excisional biopsy from all patients.
Results
: The patient's age ranged from 5 to 19 years (average age : 11.8 years). The main symptoms included a neck mass (17/19), pain in the mass (6/17), and fever (12/19). The palpable lymph nodes were mostly cervical in location; the maximum diameter, which was measured radiologically, was less than 3 cm in all 10 cases. The masses were pathologically divided into proliferative, necrotic, and xanthomatous types. With immunohistochemical staining the masses were divided into lesion (L), perilesion (PL), and necrosis (N). The CD8 staining was stronger than the CD4 staining for all regions in three types. The CD4 staining intensity was mainly increased in the perilesion, and CD8 was mainly increased in the lesion.
Conclusion
: We compared the radiologic findings, clinical symptoms, and pathology to help understand the cause of disease in patients with subacute necrotizing lymphadenitis.
Key Words: Subacute necrotizing lymphadenitis, Excisional biopsy, Immunohistochemistry


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