Kikuchi's Lymphadenitis: Role of Parvovirus B-19, EBV, HHV-6, and HHV-8 Detected by PCR in a Multi-Institutional Review of 18 Cases.
Flavia GN Rosado, Yi-Wei Tang, Robert P Hasserjian, Colt McClain, Beverly Y Wang, Claudio M Mosse. Vanderbilt University Medical Center, Nashville, TN; Massachusetts General Hospital, Boston; New York University, NY
Background: Kikuchi's lymphadenitis (KL) is an uncommon self-limited disorder that typically manifests as painless cervical lymphadenopathy and systemic symptoms, usually in young females. The clinical manifestations and pathologic findings suggest a viral etiology, yet specific etiologic agents remain unknown. While there are studies reporting a positive association of KL to Parvovirus B19 and herpesviruses, other studies have failed to find an association between these viruses and KL. To our knowledge, this current study is the largest study of KL in Western patients that used PCR testing for 4 different common viral pathogens.
Design: Archival material from 3 institutions were included, following confirmation of the diagnosis of KL by two pathologists. The age and sex-matched controls selected were comprised predominantly of negative staging lymph nodes in patients with papillary thyroid carcinoma. PCR from the paraffin-embedded tissue sections for Parvovirus B19, EBV, HHV6 and HHV-8 was performed.
Results: Eighteen cases of KL were analyzed, 12 of which (60%) were cervical lymph nodes. There were 14 females and 4 males (3.5:1); 13 (72%) were patients younger than 31 years of age (range 11-41). All the cases showed typical geographic necrosis with abundant apoptotic debris, although the degree of necrosis was variable. PCR revealed a high prevalence of parvovirus B19 in the controls (44%), whereas there were fewer positive cases seen on the KL cases (11%) (p=0.068).There were no significant differences between cases and controls tested for EBV, HHV-6 and HHV-8 (p=0.5).
Conclusions: PCR failed to reveal a positive association between KL and 4 common suspected viral agents. These findings do not support a known infectious agent in the pathogenesis of this disease.
Wednesday, March 2, 2011 1:00 PM
Poster Session VI # 229, Wednesday Afternoon