Department of Pathology, Duke University Medical Center, 1 Trent Dr, Box 3712, Durham, NC 27710, USA.
Arch Pathol Lab Med. 2010 Feb;134(2):289-93. doi: 10.5858/134.2.289.
Kikuchi-Fujimoto disease, or histiocytic necrotizing lymphadenitis, is a self-limited condition, characterized by benign lymphadenopathy with associated fevers and systemic symptoms. It most commonly affects adults younger than 40 years of age and of Asian descent. Involved lymph nodes demonstrate paracortical areas of apoptotic necrosis with abundant karyorrhectic debris and a proliferation of histiocytes, plasmacytoid dendritic cells, and CD8(+) T cells in the absence of neutrophils. Kikuchi-Fujimoto disease is thought to have 3 evolving phases: proliferative, necrotizing, and xanthomatous. The etiology is unknown, although viruses and autoimmune mechanisms have been proposed. No specific laboratory tests contribute to the diagnosis. Diagnosis requires histopathologic examination and exclusion of other factors by ancillary studies. Non-Hodgkin lymphoma and systemic lupus erythematosus should be ruled out before diagnosis of Kikuchi-Fujimoto disease, given the overlapped clinical and histologic features as well as the different therapeutic approaches. Treatment involves supportive measures, and the symptoms usually resolve spontaneously within 4 months.
菊池-藤本病，又称组织细胞性坏死性淋巴结炎，是一种自限性疾病，以良性淋巴结病伴相关发热和全身症状为特征。它最常影响 40 岁以下的成年人，且多为亚洲人。受累淋巴结表现为皮质旁区细胞凋亡性坏死，大量核碎物质和组织细胞、浆细胞样树突状细胞、CD8(+)T 细胞增殖，无中性粒细胞。菊池-藤本病被认为有 3 个进展阶段：增生期、坏死期和黄色瘤期。病因不明，尽管已经提出病毒和自身免疫机制。没有特定的实验室检查有助于诊断。诊断需要组织病理学检查，并通过辅助研究排除其他因素。在诊断菊池-藤本病之前，应排除非霍奇金淋巴瘤和系统性红斑狼疮，因为它们的临床和组织学特征重叠，以及不同的治疗方法。治疗包括支持性措施，症状通常在 4 个月内自发缓解。
