Kikuchi-Fujimoto lymphadenitis: role of parvovirus B-19, Epstein-Barr virus, human herpesvirus 6, and human herpesvirus 8

• Published in: Human pathology Vol. 44; no. 2; pp. 255 - 259
• Main Authors: Rosado, Flavia Guimaraes Nunes, MD, Tang, Yi-Wei, MD, PhD, Hasserjian, Robert Paul, MD, McClain, Colt M., MD, Wang, Beverly, MD, Mosse, Claudio A., MD, PhD
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-02-2013; Elsevier Limited
• Subjects: Adolescent; Adult; Case-Control Studies; Child; EBV; Epstein-Barr virus; Epstein-Barr Virus Infections - complications; Epstein-Barr Virus Infections - virology; Etiology; Female; Herpesviridae Infections - complications; Herpesviridae Infections - virology; Herpesvirus 4, Human - genetics; Herpesvirus 4, Human - isolation & purification; Herpesvirus 6, Human - genetics; Herpesvirus 6, Human - isolation & purification; Herpesvirus 8, Human - genetics; Herpesvirus 8, Human - isolation & purification; HHV-6; HHV-8; Histiocytic Necrotizing Lymphadenitis - pathology; Histiocytic Necrotizing Lymphadenitis - virology; Humans; Kikuchi-Fugimoto; Lymph Nodes - pathology; Lymphadenitis; Male; Middle Aged; Necrosis; Parvoviridae Infections - complications; Parvoviridae Infections - virology; Parvovirus B-19; Parvovirus B19, Human - genetics; Parvovirus B19, Human - isolation & purification; Pathology; PCR; Polymerase Chain Reaction; Roseolovirus Infections - complications; Roseolovirus Infections - virology; Viral; Young Adult; Kikuchi-Fugimoto; Etiology; Viral; HHV-6; Parvovirus B-19; EBV; HHV-8; Lymphadenitis; PCR
• ISSN: 0046-8177; 1532-8392
• DOI: 10.1016/j.humpath.2012.05.016

Summary Kikuchi-Fujimoto lymphadenitis is a self-limited disorder that typically presents in young females as painless cervical lymphadenopathy with fever, anemia, and leukopenia. The clinical manifestations and pathologic findings suggest a viral etiology, yet specific etiologic agents remain unknown. Although there are studies reporting positive associations between Kikuchi-Fujimoto lymphadenitis and parvovirus B19 and herpesviruses, other studies have failed to find an association with these viruses. To our knowledge, this current study is the largest study of Kikuchi-Fujimoto lymphadenitis in Western patients that used polymerase chain reaction testing for 4 different common viral pathogens often implicated as etiologic agents in Kikuchi-Fujimoto lymphadenitis. Archival material from 3 institutions was included, following confirmation of the diagnosis of Kikuchi-Fujimoto lymphadenitis by 2 independent pathologists. Polymerase chain reaction from the paraffin-embedded tissue sections for parvovirus B19, Epstein-Barr virus, human herpesvirus 6, and human herpesvirus 8 was performed. Eighteen cases of Kikuchi-Fujimoto lymphadenitis were analyzed, 12 of which (60%) were cervical lymph nodes. All the cases showed typical geographic necrosis with abundant apoptotic debris, although the degree of necrosis was variable. Polymerase chain reaction revealed a high prevalence of parvovirus B19 in the controls (44%); there were fewer positive cases seen in the Kikuchi-Fujimoto lymphadenitis cases (11%), but this did not reach statistical significance ( P = .25).There were no significant differences between cases and controls in the prevalence of Epstein-Barr virus, human herpesvirus 6, and human herpesvirus 8 ( P = .50 for all 3). Polymerase chain reaction failed to reveal a positive association between Kikuchi-Fujimoto lymphadenitis and 4 common suspected viral agents. These findings do not support a role for Epstein-Barr virus, human herpesvirus 6, human herpesvirus 8, or parvovirus B19 in the pathogenesis of Kikuchi-Fujimoto lymphadenitis.