Necrotizing Lymphadenitis Presenting as Mesenteric Lymphadenopathy

DOI PubMed 3 Citations 14 References

Bibliographic Information

Other Title
  • 腸間膜リンパ節に発症した壊死性リンパ節炎

Search this article

Description

A 15-year-old girl was admitted to our hospital because of fever, diarrhea, and right lower abdominal pain on November 11, 1997. Computed tomographic and ultrasound studies of the abdomen disclosed enlarged mesenteric lymph nodes. Hematologic and serologic findings included WBC 3000/μl, LDH 550 IU/l, IFN-γ 264 pg/ml, IL-6 9.74 pg/ml, sIL-2R 781 U/ml, and ferritin 720 ng/ml. Although the patient was treated with antibiotics, high fever and abdominal pain persisted with progressive anemia and leucocytopenia (1800/μl). Bone marrow aspiration specimens revealed an increase of histiocytes with phagocytosis. Appendectomy and lymphadenectomy were performed on November 21. A lymph node specimen showed necrosis with infiltration by large mononuclear cells. The resected appendix revealed reactive lymphoid hyperplasia. Based on these findings, a diagnosis of necrotizing lymphadenitis (NL) was made. The postoperative course was satisfactory and systemic symptoms resolved gradually without specific treatment. However, high fever and abdominal pain recurred with right cervicial lymph node swelling on December 15. The patient's general condition improved after treatment with prednisolone. In NL, lymphadenopathy is usually observed in the cervical region, and the involvement of intra-abdominal lymph nodes is quite rare. Our findings indicated the possibility that IFN-γ may play an important role in the pathogenesis of NL with hemophagocytic syndrome.

Journal

  • Rinsho Ketsueki

    Rinsho Ketsueki 40 (8), 658-662, 1999

    The Japanese Society of Hematology

Citations (3)*help

See more

References(14)*help

See more

Keywords

Details 詳細情報について

Report a problem

Back to top