BACKGROUND Although Kikuchi's lymphadenitis (KL) has been known to have characteristic cytological features, pathologists encounter difficulties in making a diagnosis with fine needle aspiration cytology (FNAC). The objective of this study was to assess the diagnostic pitfalls of KL with FNAC, particularly with emphasis on differential diagnosis with tuberculosis. METHODS FNAC of 10 patients with a histological diagnosis of KL and tuberculosis was reviewed. RESULTS Acidophilic cells were observed in all the 10 KL cases, even if the smears were insufficient. Crescentic histiocytes were seen in 8, granular background in 7, and karyorrhectic debris in 3 cases. Epithelioid histiocytes or neutrophils were not seen in any of the KL cases. Of the 10 cases of tuberculosis, acidophilic cells were observed in 6 cases, crescentic histiocytes in none of them, cheese-like background in 9, karyorrhectic debris in 8, epithelioid histiocytes in 4, and neutrophils in 8 cases. CONCLUSIONS The acidophilic cell could be the most sensitive but not the specific marker of KL with FNAC. The crescentic histiocytes might be the sensitive and considerably specific marker of KL. The cytological features distinguishing tuberculosis from KL may be cheese-like necrosis admixed with neutrophils and epithelioid histiocytes.
Citations
Citations to this article as recorded by
Kikuchi–Fujimoto disease in the Eastern Mediterranean zone Abdel Rahman Al Manasra, Hamzeh Al-Domaidat, Mohd Asim Aideh, Doaa Al Qaoud, Majd Al Shalakhti, Sohaib Al khatib, Jehad Fataftah, Raed Al-Taher, Mohammad Nofal Scientific Reports.2022;[Epub] CrossRef
The fine-needle aspiration cytology and clinical findings of Kikuchi–Fujimoto disease in pediatric patients: a retrospective clinical study Yuto Naoi, Tomoyasu Tachibana, Yoji Wani, Machiko Hotta, Katsuya Haruna, Yasutoshi Komatsubara, Kazunori Kuroda, Soichiro Fushimi, Tami Nagatani, Yuko Kataoka, Kazunori Nishizaki, Yasuharu Sato, Mizuo Ando Acta Oto-Laryngologica.2022; 142(3-4): 340. CrossRef
Identification of Torque Teno Virus/Torque Teno-Like Minivirus in the Cervical Lymph Nodes of Kikuchi-Fujimoto Lymphadenitis Patients (Histiocytic Necrotizing Lymphadenitis): A Possible Key to Idiopathic Disease Yosep Chong, Ji Young Lee, Chang Suk Kang, Eun Jung Lee Biomedicine Hub.2020; 5(1): 1. CrossRef
Morphology quiz: Enigma of a cervical lymph node Sudha Sharma Cytopathology.2019; 30(6): 676. CrossRef
Kikuchis lymphadenitis: Is biopsy necessary in managing these patients Hemalatha Anantharamaiah, Sagayaraj Arokiyaswamy, ChinaiahS. B. R. Prasad International Journal of Medicine and Public Health.2015; 5(1): 115. CrossRef
Causative agents of Kikuchi–Fujimoto disease (histiocytic necrotizing lymphadenitis): A meta-analysis Yosep Chong, Chang Suk Kang International Journal of Pediatric Otorhinolaryngology.2014; 78(11): 1890. CrossRef