Lymph node architecture shows focal to confluent necrosis.
Karyorrhectic debris with histiocytes at necrotic margin.
However, neutrophils missing in action.
No granuloma, no atypical or giant cells
- Diagnostic pearls :
- Think kikuchi in young females with fever and cervical nodes🤔😎
Must Rule out SLE with ANA, dsDNA.
If neutrophils dominate consider bacterial suppurative lymphadenitis
TB or fungal- Granuloma should be there, not just necrosis
Next steps (clinically )-
Autoimmune work up :ANA, dsDNA (to rule out SLE)
Follow up : most idiopathic cases are self limiting
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