Distinguishing lupus lymphadenitis from Kikuchi disease based on clinicopathological features and C4d immunohistochemistry
| Autor: | Shan Chi Yu, Chun Nan Chen, Tsung-Lin Yang, Ko Chin Chen, Meng Fang Li, Wei Chou Lin, Hsuan Wang, Chih Jung Chen, Yueh Min Lin, Kung Chao Chang, Chieh Yu Shen, Long Wei Lin, Po Yen Kuo |
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| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Male medicine.medical_specialty Pathology Kikuchi disease Stain Diagnosis Differential Machine Learning 03 medical and health sciences 0302 clinical medicine Rheumatology Lymphadenitis Biopsy medicine Complement C4b Humans Lupus Erythematosus Systemic Pharmacology (medical) Histiocytic Necrotizing Lymphadenitis Retrospective Studies 030203 arthritis & rheumatology medicine.diagnostic_test business.industry Plasmacytosis Middle Aged medicine.disease Peptide Fragments Staining 030104 developmental biology Immunohistochemistry Histopathology Female Lymph Nodes business Generalized lymphadenopathy |
| Zdroj: | Rheumatology (Oxford, England). 60(3) |
| ISSN: | 1462-0332 |
| Popis: | Objectives Distinguishing Kikuchi disease (KD) from lupus lymphadenitis (LL) histologically is nearly impossible. We applied C4d immunohistochemical (IHC) stain to develop diagnostic tools. Methods We retrospectively investigated clinicopathological features and C4d IHC staining in an LL-enriched development cohort (19 LL and 81 KD specimens), proposed risk stratification criteria and trained machine learning models, and validated them in an external cohort (2 LL and 55 KD specimens). Results Clinically, we observed that LL was associated with an older average age (33 vs 25 years; P=0.005), higher proportion of biopsy sites other than the neck [4/19 (21%) vs 1/81 (1%); P=0.004], and higher proportion of generalized lymphadenopathy compared with KD [9/16 (56%) vs 7/31 (23%); P=0.028]. Histologically, LL involved a larger tissue area than KD did (P=0.006). LL specimens exhibited more frequent interfollicular pattern [5/19 (26%) vs 3/81 (4%); P=0.001] and plasma cell infiltrates (P=0.002), and less frequent histiocytic infiltrates in the necrotic area (P=0.030). Xanthomatous infiltrates were noted in 6/19 (32%) LL specimens. Immunohistochemically, C4d endothelial staining in the necrotic area [11/17 (65%) vs 2/62 (3%); P Conclusions Integrating clinicopathological and C4d findings could distinguish LL from KD. |
| Databáze: | OpenAIRE |
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