Lymph nodes & spleen, nonlymphoma

Lymph nodes-inflammatory / reactive disorders

Kikuchi disease

Topic Completed: 1 July 2006

Minor changes: 22 October 2021

Copyright: 2003-2021,, Inc.

PubMed Search: Kikuchi disease[TI]

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Cite this page: DePond WD. Kikuchi disease. website. Accessed October 24th, 2021.
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

AFIP images

Kikuchi necrotizing lymphadenitis

Contributed by Mark R. Wick, M.D.

Kikuchi lymphadenitis

Case #89

Various images

Images hosted on other servers:

Various images

Lymph node with necrosis

Necrotic foci in lymph node

Pyknotic cells and histiocytes at edge of necrosis

Mixed inflammatory infiltrate

Histiocytes with ingested nuclear debris

With SLE

Resembling signet ring cell carcinoma

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

#2 with tubuloreticular structures

Molecular / cytogenetics description
Differential diagnosis
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