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KMID : 1130320080510111198
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Korean Journal of Pediatrics
2008 Volume.51 No. 11 p.1198 ~ p.1204
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Analysis of disease mechanism of subacute necrotizing lymphadenitis in children
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Kim Hyun-Jung
Yeom Jung-Sook
Park Ji-Sook
Park Eun-Sil
Seo Ji-Hyun
Lim Jae-Young
Park Chan-Hoo
Woo Hyang-Ok
Cho Jae-Min
Lee Jeong-Hee
Youn Hee-Sang
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Abstract
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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 1 9 lymph node tissue specimens from 1 7 children diagnosed with subacute necrotizing lymphadenitis at Gyeongsang National University Hospital from March, 1 9 9 8 to July, 2 0 0 6 . 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 1 9 years (average age :1 1 .8 years). The main symptoms included a neck mass (1 7 /1 9 ), pain in the mass (6 /1 7 ), and fever (1 2 /1 9 ). The palpable lymph nodes were mostly cervical in location; the maximum diameter, which was measured radiologically, was less than 3 cm in all 1 0 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.
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KEYWORD
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Subacute necrotizing lymphadenitis, Excisional biopsy, Immunohistochemistry
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