Diagnosing Kikuchi's Disease on fine needle aspiration biopsy

Miao Wang, Xiaomeng Yu, Yan Yang
Cytopathology: Official Journal of the British Society for Clinical Cytology 2019 July 14

OBJECTIVE: To investigate the diagnostic utility of fine needle aspiration (FNA) smear, cell block (CB), flow cytometry (FC) and tuberculosis PCR (Tb-PCR) analysis for Kikuchi's Disease(KD).

METHODS: 173 FNA biopsy samples were collected using a Youyi aspirator. KD was diagnosed by FNA smear, with or without, CB, FC, and Tb-PCR.

RESULTS: Out of 173 patients, 131 (75.7%) were female and 126 (72.8%) are among 21-40 years old. 171 patients (98.8%) presented with painful enlarged cervical lymph nodes . All cytological samples identified intracellular apoptotic debris which was embedded in the cytoplasm of crescentic and phagocytic macrophages. In 24 CBs, clusters of CD123 positive plasmacytoid monocytes were observed in KD. FC and CBs showed non-specific lymphoid hyperplasia in 9 cases with suspicious lymphoma. Tb-PCR was negative in 5 cases with suspicious tuberculosis.

CONCLUSIONS: In summary, FNA biopsy is a fast, reliable, and relatively inexpensive diagnosis tool for KD. CB preparation is an important adjunct method for the diagnosis of KD.

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