菊地氏（Kikuchi’s）病---病例報告及文獻回顧

1 taiwan MEDICAL JOURNAL2008, , Kikuchi s --- / * * (Kikuchi s disease) 1972 Kikuchi Fujimoto 2 0 3 0 1 4 2007 1 1 23 1 2007 1 C 1 2 1 1 1700/ L C3 C4 rheumatic factor ANA

2 EBV-CA 1 4 x x 2 ( 3) H&E 4 5 histiocytic necrotizing lymphadenitis 1 2300/ L 1 1 1 9 7 2 K i k u c h i Fujimoto (histiocytic necrotizing lymphadenitis ) 1 T 1 2 4 322 taiwan MEDICAL JOURNAL192008, , 2-4 1 2003 Lin 1.

3 1 5 21 30 40 6 6 EBV CMV HHV-6 HHV-8 HTLV-1 HBV P a r o v i r u s 7 lysozyme,myeloperoxidase CD68 Ohshima CD8+ T perforine Fas 8 6 Ohshima interferon-r(IFN-r) Fas-L IL-6 convalescent phase 8 Ye r s i n i a enterocolitica Toxoplasma gondii 6 Yersinia enterocolitica Toxoplasma gondii Yersinia enterocolitica mesenteric lymphadenitis Toxoplasma gondii toxoplasmic lymphadenitis 6 1996 6 3 1 1 4 H&E 40X 5 H&E 400X 323 taiwan MEDICAL JOURNAL2008.

4 Antiphospholipid syndrome 6 2 3 56-98% ( ) 59% 4cm 6 1 22% 30 50% 9-12 25-58% 25 31% 16 40% 9 23% 8% 7% (ANA) 6%LDH 4% 1,10-12 13 T I m a m u r a (transformed) 6,14 H&E (plasmacytoid m o n o c y t e s ) (crescentic histiocytes) 5 0 - 6 0 % r e a c t i v e l y m p h o i d folliculitis Kuo 3 proliferation necrotizing( ) xanthomatosis(foamy histiocytes) 11 60-70% 63D3(anti63D3) 30-40% leu-2A T CD68 6 5 6.

5 3 % 3 1 . 2. 3. 15,16 Kawasaki 1 Hodgkin s lymphoma Reed-Sternberg (microabscess) CD4 2 3 : T (hematoxylin bodies) 4 Kawasaki disease (graphic necrosis) (fibrinoid thrombosis) 5 turberculosis (Langerhans,cell) 2,16 1 4 1 6 3% 4% 8 9 NSAID 6,11,12 Dorfman Berry324 taiwan MEDICAL JOURNAL212008, , 2 1 2,17 2003 Hu 18 1.

6 Ahmad M, Khan AB, Iqbal J: Histiocytic necrotizing lymphadenitis: a clinicopathological study. J Pak Med Assoc 1991;41 RF, Berry GJ: Kikuchi's histiocytic necrotizing lymphadenitis: an analysis of 108 cases with emphasis on differential diagnosis. Semin Diagn Pathol 1998;5: WYW, Chan JKC, Ng CS: Kikuchi s lymphadenitis: a m o r p h o l o g i c a n a l y s i s of 75 c a s e s w i t h s p e c i a l referenc e to unusual fe ature s. A m J Sur g Pat ho l 1994;18 k a n o Y, S a e g u s a M ,O k u d a r i r u s M : Pa t h o l o g i c a n a l y s e s o f n o n o v e r t n e c r o t i z i n g t y p e K i k u c h i a n d Fu j i m o t o s d i s e a s e.

7 A c t a P a t h o l o g i c a J a p a n 1993;43 HC, Su CY, Huang CC, et al.: Kikuchi's disease: a review and analysis of 61 cases. Otolaryngol Head Neck Surg 2003;128 X, Guilabert A, Miquel R,et al.: Enigmatic Kikuchi-Fujimoto disease: a comprehensive review. Am J Clin Pathol 2004;122 CF, Chow KC, Lin T Y, et al.: Virus infection in patients with histiocytic necrotizing lymphadenitis in taiwan :detection of Epstein-Barr virus, type I human T-cell lymphotropic virus, and parvovirus B19. Am J Clin Pathol 2000;113 K, Shimazaki K, Kume T, et al.: Perforin and Fa s p a t h w a y s o f c y t o t o x i c T- c e l l s i n h i s t i o c y t i c n e c r o t i z i n g l y m p h a d e n i t i s.

8 H i s t o p a t h o l o g y 1998;33 K, Ohshima K, Anzai K, et al.: Elevated serum-s o l u b l e F a s l i g a n d i n h i s t i o c y t i c n e c r o t i z i n g lymphadenitis. Int J Hematol 2001;73 AS, Pileri A, Yasukawa K, et al.: The Karma of Kikuchi's disease. Clin Immunol 2005;114 Kuo T: K ikuc hi 's disease (hist io cy t ic nec rot izing l y m p h a d e n i t i s): A c l i n i c o p a t h o l o g i c s t u d y o f 7 9 c a s e s w i t h a n a n a l y s i s o f h i s t o l o g i c s u b t y p e s , immunohistology, and DNA ploidy. Am J Surg Pathol 1995;19 Y, Solmazgul E, Kunter E, et al.

9 : Kikuchi Fu j i m o t o D i s e a s e : a n a l y s i s o f 2 4 4 c a s e s . C l i n Rheumatol 2007; 26 SY, Kim TK, Kim YS,et al.: CT Findings in Kikuchi disease:analysis of 96 Am J Neuroradiol 2004;25 4 . I m a m u r a M , U e n o H , M a t s u u r a A , e t a l . : A n u l t r a s t r u c t u r a l s t u d y o f s u b a c u t e n e c r o t i z i n g lymphadenitis. Am J Pathol 1982;107 TR , Chan OW, Lee KC: Diagnosing Kikuchi d i s e a s e o n f i n e n e e d l e a s p i r a t i o n b i o p s y : a retrospective study of 44 cases diagnosed by cytology and 8 by histopathology. Acta Cytol 2001;45.

10 Ts an g W Y W, Chan J KC: Fine - ne e dl e asp ir at i o n cytologic diagnosis of Kikuchi's lymphadenitis: a report of 27 cases. Am J Clin Pathol 1994;102 JK,Wong KC,Ng CS: A fatal case of multicentric Kikuchi's histiocytic necrotizing lymphadenitis. Cancer 1989;63 . H u S , K u o T T, H o n g H S: L u p u s l y m p h a d e n i t i s simulating Kikuchi's lymphadenitis in patients with systemic lupus erythematosus: a clinicopathological analysis of six cases and review of the literature. Pathol Int 2003;53