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Diagnosis of Kikuchi-Fujimoto disease: a comparison between open biopsy and minimally invasive ultrasound-guided core biopsy.

Yu SC, Chen CN, Huang HI, Chen TC, Wang CP, Lou PJ, Ko JY, Hsiao TY, Yang TL - PLoS ONE (2014)

Bottom Line: Similar pathological presentations were found both in the specimens of USCB and OB.Sampling errors were found both in USCB and OB.OB can be applied only in the failed cases of USCB.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, National Taiwan University Hospital, Taiwan.

ABSTRACT
Kikuchi-Fujimoto disease (KFD) is a self-limited disease without any need of surgical treatments. Sampling of tissue is the only invasive procedure during the clinical course. However, the standard sampling procedure with accuracy, minimal invasiveness, and esthetic maintenance has not been established yet. In this study, a retrospective review of clinical utility and pathological presentations of the ultrasound-guided core biopsy (USCB) and the open biopsy (OB) in consecutive KFD patients. From 2010 to 2012, 34 consecutive patients were enrolled. USCB was performed in 11 patients, and OB was done in 26 patients. KFD was confirmed in 82% cases by USCB. Similar pathological presentations were found both in the specimens of USCB and OB. In the three patients who had received both USCB and OB, KFD was confirmed by USCB in one case, while two by OB. Sampling errors were found both in USCB and OB. For diagnosing KFD, USCB can serve as the first-line diagnostic tool. OB can be applied only in the failed cases of USCB.

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Related in: MedlinePlus

Representative photographs of a USCB specimen.a. Necrosis was mixed with karyorrhexis and histiocytes (H&E, 400x). b. Conspicuous karyorrhexis accompanied by histiocyte aggregation (H&E, 400x). c. Clustered plasmacytoid dendritic cells highlighted by CD123 (200x). d. Increased histiocytes were observed (H&E, 400x).
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pone-0095886-g005: Representative photographs of a USCB specimen.a. Necrosis was mixed with karyorrhexis and histiocytes (H&E, 400x). b. Conspicuous karyorrhexis accompanied by histiocyte aggregation (H&E, 400x). c. Clustered plasmacytoid dendritic cells highlighted by CD123 (200x). d. Increased histiocytes were observed (H&E, 400x).

Mentions: In addition to the specimens harvested from OB, the pathological findings of those from USCB were reviewed. The pathological presentation of individual USCB specimen was listed in table 4. Diagnosis was made by USCB alone in case 1 to 9. The diagnosis of case 10 and 11 was confirmed by subsequent OB. Necrosis and karyorrhexis were distinctive features of KFD in USCB specimens. Necrosis was mixed with karyorrhexis and histiocytes in 5 cases (45%) (Fig 5a). Karyorrhexis was present in 9 cases (82%), either in necrotic or viable area (Fig 5b). Crescentic histiocytes were noted in 9 cases (82%). Clustered plasmacytoid dendritic cells was present in 7 cases (64%) (Fig 5c). Histiocyte infiltration was found in 11 cases (100%) (Fig 5d). No foamy histiocytes, multinucleate giant cells or granuloma formation was noted. Plasma cells were present in one case (9%).


Diagnosis of Kikuchi-Fujimoto disease: a comparison between open biopsy and minimally invasive ultrasound-guided core biopsy.

Yu SC, Chen CN, Huang HI, Chen TC, Wang CP, Lou PJ, Ko JY, Hsiao TY, Yang TL - PLoS ONE (2014)

Representative photographs of a USCB specimen.a. Necrosis was mixed with karyorrhexis and histiocytes (H&E, 400x). b. Conspicuous karyorrhexis accompanied by histiocyte aggregation (H&E, 400x). c. Clustered plasmacytoid dendritic cells highlighted by CD123 (200x). d. Increased histiocytes were observed (H&E, 400x).
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4008434&req=5

pone-0095886-g005: Representative photographs of a USCB specimen.a. Necrosis was mixed with karyorrhexis and histiocytes (H&E, 400x). b. Conspicuous karyorrhexis accompanied by histiocyte aggregation (H&E, 400x). c. Clustered plasmacytoid dendritic cells highlighted by CD123 (200x). d. Increased histiocytes were observed (H&E, 400x).
Mentions: In addition to the specimens harvested from OB, the pathological findings of those from USCB were reviewed. The pathological presentation of individual USCB specimen was listed in table 4. Diagnosis was made by USCB alone in case 1 to 9. The diagnosis of case 10 and 11 was confirmed by subsequent OB. Necrosis and karyorrhexis were distinctive features of KFD in USCB specimens. Necrosis was mixed with karyorrhexis and histiocytes in 5 cases (45%) (Fig 5a). Karyorrhexis was present in 9 cases (82%), either in necrotic or viable area (Fig 5b). Crescentic histiocytes were noted in 9 cases (82%). Clustered plasmacytoid dendritic cells was present in 7 cases (64%) (Fig 5c). Histiocyte infiltration was found in 11 cases (100%) (Fig 5d). No foamy histiocytes, multinucleate giant cells or granuloma formation was noted. Plasma cells were present in one case (9%).

Bottom Line: Similar pathological presentations were found both in the specimens of USCB and OB.Sampling errors were found both in USCB and OB.OB can be applied only in the failed cases of USCB.

View Article: PubMed Central - PubMed

Affiliation: Department of Pathology, National Taiwan University Hospital, Taiwan.

ABSTRACT
Kikuchi-Fujimoto disease (KFD) is a self-limited disease without any need of surgical treatments. Sampling of tissue is the only invasive procedure during the clinical course. However, the standard sampling procedure with accuracy, minimal invasiveness, and esthetic maintenance has not been established yet. In this study, a retrospective review of clinical utility and pathological presentations of the ultrasound-guided core biopsy (USCB) and the open biopsy (OB) in consecutive KFD patients. From 2010 to 2012, 34 consecutive patients were enrolled. USCB was performed in 11 patients, and OB was done in 26 patients. KFD was confirmed in 82% cases by USCB. Similar pathological presentations were found both in the specimens of USCB and OB. In the three patients who had received both USCB and OB, KFD was confirmed by USCB in one case, while two by OB. Sampling errors were found both in USCB and OB. For diagnosing KFD, USCB can serve as the first-line diagnostic tool. OB can be applied only in the failed cases of USCB.

Show MeSH
Related in: MedlinePlus