Lymph nodes - not lymphoma
Inflammatory disorders (noninfectious)
Kikuchi disease

Topic Completed: 1 July 2006

Revised: 5 February 2019, last major update June 2006

Copyright: (c) 2003-2018,, Inc.

PubMed Search: Kikuchi disease[TI]

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Cite this page: DePond W. Kikuchi disease. website. Accessed October 13th, 2019.
Definition / general
Case reports
Microscopic (histologic) description
  • Paracortical, well circumscribed necrotic lesions, often with a starry sky appearance
  • Karryorhexis, fibrin deposits, plasmacytoid monocytes (2 - 3x size of small lymphocytes, variable cytoplasm, round nuclei with open chromatin, small nucleoli, CD4+) that may resemble lymphoma, phagocytic and foamy histiocytes, T cells (CD8+, cytotoxic phenotype)
  • No / rare plasma cells, no neutrophils, no follicular hyperplasia, no atypia
  • Occasionally no overt necrosis (Am J Surg Pathol 1990;14:514)

Skin biopsies:
  • Vacuolar interface change with necrotic keratinocytes, dense superficial lymphohistiocytic infiltrate, deep perivascular and interstitial lymphohistiocytic infiltrate
  • Abundant karyorrhectic debris but rare / no neutrophils or plasma cells (Am J Surg Pathol 1999;23:1040, Am J Surg Pathol 1990;14:872)
Microscopic (histologic) images

Images hosted on PathOut server:

AFIP images:

Kikuchi necrotizing lymphadenitis

Contributed by Dr. Mark R. Wick:

Kikuchi lymphadenitis

Case of the Week #89:

Various images

Images hosted on other servers:

Various images

Lymph node with
necrosis and

Necrotic foci in lymph node

Well preserved cells,
pyknotic cells and
histiocytes at edge
of necrosis

Mixed inflammatory
infiltrate includes
histiocytes with
necrotic debris

Histiocytes with ingested nuclear debris

With SLE

Resembling signet
ring cell carcinoma
of stomach (inset
CD68+ histiocytes)

Reticulin stain shows preserved vessel outlines

Cytology description
  • Phagocytic histiocytes with peripheral nuclei and plasmacytoid monocytes
Electron microscopy description
  • Tubuloreticular structures and intracytoplasmic rods, similar to lupus
Electron microscopy images

Images hosted on other servers:

Histiocytes with myelin figures (HC), lymphocytes (L) and plasmacytoid cells (P) and transformed lymphocytes #1 (TL)

#2 with tubuloreticular structures (TRS) - inset

Molecular / cytogenetics description
Differential diagnosis
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