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World Journal of Gastroenterology 2013年第48期19卷 9490-9494页

作者： Li-Mei Qu Ya-Hui Liu David R Brigstock Xiao-Yu Wen Yong-Fang Liu Ya-Jun Li Run-Ping Gao Department of Hepatic-Biliary-Pancreatic Medicine First Hospital Jilin University Department of Hepatic-Biliary-Pancreatic Surgery First Hospital Jilin University The Research Institute at Nationwide Children’s Hospital Columbus OH 43205 United States Division of Pediatric Surgery Department of Surgery The Ohio State University Columbus OH 43205United States

Autoimmune pancreatitis(AIP)is a form of chronic pancreatitis that is categorized as type 1 or type 2according to the clinical *** 1 AIP,which predominantly presents in a few Asian countries,is a hyper-IgG4-related *** report a case of IgG4-related AIP overlapping with Mikulicz’s disease and lymphadenitis,which is rare and seldom reported in literature.A 63-year male from Northeast China was admitted for abdominal distension lasting for one *** presented symmetric swelling of the parotid and submandibular glands with slight dysfunction of salivary secretion for 6 *** had a 2-year history of bilateral submandibular lymphadenopathy without *** underwent surgical excision of the right submandibular lymph node one year prior to *** denied any history of alcohol,tobacco,or illicit drug *** examination revealed high fasting blood sugar level(8.8 mmol/L)and high level of IgG4(15.2 g/L).Anti-SSA or anti-SSB were *** tomography of the abdomen showed a diffusely enlarged pancreas with loss of *** stain for IgG4 demonstrated diffuse infiltration of IgG4-positive plasma cells in labial salivary gland and lymph node biopsy *** patient received a dose of 30 mg/d of prednisone for three *** this three-week follow-up,the patient reported no discomfort and his swollen salivary glands,neck lymph node and pancreas had returned to normal *** patient received a maintenance dose of 10mg/d of prednisone for 6 mo,after which his illness had not recurred.

关键词： IgG4-related disease Type 1 autoimmune pancreatitis Mikulicz’s disease lymphadenitis

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Disseminated cryptococcal lymphadenitis with negative latex agglutination test

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Chinese Medical Journal 2012年第13期125卷 2393-2396页

作者： XU Xiao-guang BI Xin-ling WU Jian-hua XU Hong LIAO Wan-qing Department of Dermatology Changhai Hospital Second Military Medical University Shanghai 200433 China Institute of Dermatology and Mycosis of Changzheng Hospital Second Military Medical University Shanghai 200003 China

We reported an unusual case of disseminated cryptococcal lymphadenitis in an immunocompetent host who presented with fever and lymphadenopathy, which were the only two symptoms and signs. Latex agglutination test of serum and cerebrospinal fluid （CSF） were negative, while lymph node biopsy showed Cryptococcus neoformans. A diagnosis of disseminated cryptococcal lymphadenitis was made. Then the patient was treated with amphotericin B for 15 days as initial therapy and itraconazole for 6 months as maintenance therapy respectively. The patient received re-examination per 6 months and was followed up for 2 years. Swollen lymph nodes diminished gradually, and no fever or other symptoms were found. Latex agglutination test of serum and CSF were negative throughout the follow-up period, and anti-HIV, syphilis and tuberculosis antibody were all negative.

关键词： Cryptococcus neoformans lymphadenitis latex agglutination test immunocompetence

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Cervical Nontuberculous Mycobacterial lymphadenitis Mimicking a Thyroid Tumor and Infiltrating Deep into the Neck

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Surgical Science 2012年第12期3卷 561-563页

作者： Kazuhiro Mino Tadao Okada Shouhei Honda Hisayuki Miyagi Nobuhisa Ishiguro Kanako C. Kubota Taketomi Akinobu Department of Gastroenterological Surgery I Hokkaido University Graduate School of Medicine Sapporo Japan Department of Pediatrics Hokkaido University Graduate School of Medicine Sapporo Japan Department of Surgical Pathology Hokkaido University Hospital Sapporo Japan

Aim: Nontuberculous Mycobacterial lymphadenitis (NML), which occurs in 1.2 per 100,000 children, is very rare. And those which emerge at the anterior cervical portion and infiltrate deep into the neck are even more rare. Generally, this disorder is uncommon existed near the thyroid gland. We report here a case of NML mimicking a thyroid tumor and infiltrating into the deep part of the anterior neck. Case: A mass at the anterior portion of her neck was found at 5 years old. It was not mobile and palpated as an irregularly surfaced hard mass whose size was 3 cm at the anterior lower portion of her neck. Ultrasonography showed an oval mass which existed near the slightly inferior part of the right lobe of the thyroid gland. Enhanced computed tomography showed a mass near the slightly inferior part of the right lobe of the thyroid gland. The mass was resected with the platysma and the right sternohyoid muscle. In the HE staining, epithelioid cell and Langhans type giant cells surrounding coagulative necrosis lesions which seemed to be caseation necrosis existed, similarly to cervical NML. Discussion: No consensus exists for the treatment of NML, but many documents advise complete excision. When the lesion cannot be completely removed, excision as far as possible and additional antibiotics are recommended. The characteristics of imaging of NML around the thyroid gland and infiltrating deep into the anterior neck and mediastinum are discussed.

关键词： Anterior Cervical Portion Mediastinum Nontuberculous Mycobacterial lymphadenitis Thyroid Gland

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Postoperative reactive lymphadenitis: A potential cause of false-positive FDG PET/CT

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World Journal of Radiology 2014年第12期6卷 890-894页

作者： Yiyan Liu Nuclear Medicine Service Department of Radiology Rutgers University Hospital

A wide variety of surgical related uptake has been reported on F18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography(FDG PET/CT) scan, most of which can be differentiated from neoplastic process based on the pattern of FDG uptake and/or anatomic appearance on the integrated CT in image interpretation. A more potential problem we may be aware is postoperative reactive lymphadenitis, which may mimic regional nodal metastases on FDG PET/CT. This review presents five case examples demonstrating that postoperative reactive lymphadenitis could be a false-positive source for regional nodal metastasis on FDG PET/CT. Surgical oncologists and radiologists should be aware of reactive lymphadenitis in interpreting postoperative restaging FDG PET/CT scan when FDG avid lymphadenopathy is only seen in the lymphatic draining location from surgical site.

关键词： lymphadenitis F18-fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography False-positive Lymphadenopathy

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Kawasaki disease with peritonsillar abscess as the first symptom:A case report

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World Journal of Clinical Cases 2023年第22期11卷 5391-5397页

作者： Li-Man Huo Li-Min Li Hao-Yang Peng Li-Jia Wang Zhang-Ying Feng Department of Pharmacy The Fourth Hospital of Hebei Medical UniversityShijiazhuang 050011Hebei ProvinceChina Department of Paediatrics The Fourth Hospital of Hebei Medical UniversityShijiazhuang 050011Hebei ProvinceChina Department of Ultrasound The Fourth Hospital of Hebei Medical UniversityShijiazhuang 050011Hebei ProvinceChina Department of Medical Imaging The Fourth Hospital of Hebei Medical UniversityShijiazhuang 050011Hebei ProvinceChina Department of Clinical Pharmacology The Fourth Hospital of Hebei Medical UniversityShijiazhuang 050011Hebei ProvinceChina

BACKGROUND Kawasaki disease(KD),also known as mucocutaneous lymph node syndrome,is an acute,self-limiting vasculitis of unknown aetiology that mainly involves the medium and small arteries and can lead to serious cardiovascular complications,with a 25%incidence of coronary artery ***–Sillar abscesses are a rare symptom of KD and is easily misdiagnosed at its early *** SUMMARY A 5-year-old boy who presented to a community hospital with a 3-d fever,difficulty in opening his mouth,and neck pain and was originally treated for throat infection without *** the basis of laboratory tests,ultrasound of submandibular and superficial lymph nodes and computed tomography of the neck,the clinician diagnosed the periamygdala abscess and sepsis that did not resolve after antibiotic *** the fifth day of admission,the child developed conjunctival congestion,prune tongue,perianal congestion and desquamation,and slightly stiff and swollen bunions on both feet.A diagnosis of KD was reached with complete remission after intravenous immunoglobulin *** Children with neck pain,lymph node enlargement,or airway obstruction as the main manifestations are poorly treated with intravenous broad-spectrum *** should not rush invasive operations such as neck puncture,incision,and drainage and should be alert for KD when it cannot be explained by deep neck space infection and early treatment with aspirin combined with gammaglobulin.

关键词： Peritonsillar abscess Kawasaki disease Deep neck space involvement lymphadenitis Gammaglobulin Case report

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Fatality in Kikuchi-Fujimoto disease: A rare phenomenon

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World Journal of Clinical Cases 2017年第2期5卷 35-39页

作者： Bianca Barbat Ruby Jhaj Daniyeh Khurram Providence-Providence Park Hospital

Kikuchi-Fujimoto disease(KFD), also known as histiocytic necrotizing lymphadenitis, is an uncommon condition, typically characterized by lymphadenopathy and fevers. It usually has a benign course; however, it may progress to fatality in extremely rare occasions. The diagnosis is made via lymph node biopsy and histopathology. Our patient was a young female who presented with shortness of breath, fever, and malaise. Physical examination revealed significant cervical and axillary lymphadenopathy. Chest X-ray displayed multilobar pneumonia. She required intubation and mechanical ventilation for progressive respiratory distress. Histopathology of lymph nodes demonstrated variable involvement of patchy areas of necrosis within the paracortex composed of karyorrhectic debris with abundant histiocytes consistent with KFD. After initial stabilization, the patient's condition quickly deteriorated with acute anemia, thrombocytopenia and elevated prothrombin time, partial prothrombin time, and D-dimer levels. Disseminated intravascular coagulopathy(DIC) ensued resulting in the patient's fatality. DIC in KFD is not well understood, but it is an important cause of mortality in patients with aggressive disease.

关键词： Kikuchi-Fujimoto disease Disseminated intravascular coagulopathy Histiocytic necrotizing lymphadenitis Lymphadenopathy Fatality

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228 CASES OF PAINFUL SWELLING OF THE YANG-HEAT TYPE TREATED BY COMPRESS WITH XIAO ZHONG SAN

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Journal of Traditional Chinese Medicine 1998年第3期18卷 205-208页

作者：石新德安宝华张子明 Beijing Tiantan Hospital of Traditional Chinese Medicine Beijing 100061 Beijing Administrative Bureau of Traditional Chinese Medicine Handan Hospital of Traditional Chinese Medicine Hebei Province

Painful swelling of the yang-heat type can be seen in many kinds of yang-heat syndromes of surgery, gynecology and pediatrics, and in some complications of internal medicine. Since 1987, we have successfully treated 228 cases of different painful swelling syndromes of the yang-heat type by compress with Xiao Zhong San (消肿散), which was developed through repeated scanning on the basis of an ancient prescription of Tiao Wei Cheng Qi Tang (调胃承气汤) described in Treatise on Febrile Diseases written by Zhang Zhongjing. This is reported as follows.

关键词： Administration, Topical Adolescent Adult Child Child, Preschool Diagnosis, Differential Drugs, Chinese Herbal Female Humans lymphadenitis Male Mastitis Medicine, Chinese Traditional Middle Aged Mumps Powders

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Kikuchi-Fujimoto Disease Mimicking Tuberculosis

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International Journal of Clinical Medicine 2015年第10期6卷 725-728页

作者： Madiha Mahfoudhi Imen Gorsane Sami Turki Taieb Ben Abdallah Department of Internal Medicine A Charles Nicolle Hospital Tunis Tunisia

A 32-year-old woman presented with a fever and cervical lymphadenopathies. The research for Mycobacterium tuberculosis was negative. Tuberculin skin test was positive. Laboratory investigations showed an elevated erythrocyte sedimentation rate and a normal white blood cell count. Bacteriological and viral investigations were negative. Quantiferon-Tb Gold test was indeterminate. Thraco-abdominal and pelvic computed tomography, FDG-PET and gallium scintigraphy revealed no abnormalities. Histological study of cervical lymph node biopsy found signs in favor of histiocytic necrotizing lymphadenitis. There were no epithelioid cell granulomas. A test tuberculosis treatment was refused by the patient. The evolution was marked by spontaneous clinical and biological resolution in fifty days. The negative Lowenstein-Jensen culture eliminated formally the tuberculosis. KFD was thus the most likely diagnosis.

关键词： Kikuchi-Fujimoto Disease Mycobacterium tuberculosis lymphadenitis Histology

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An audit of Paediatric Orofacial Lesions at the Kilimanjaro Christian Medical Centre in Moshi, Tanzania

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Surgical Science 2011年第10期2卷 476-480页

作者： D. S. Rwakatema M. L. Chindia 不详

Objective: To audit and categorize pathological lesions and conditions that occurred in the orofacial region among children aged up to 15 yrs. Setting: Kilimanjaro Christian Medical Centre, Moshi, Tanzania. Design: Retrospective cross-sectional audit based on archival records and material between 1985 to 2005. Results: Biopsy results were generated into 11 categories whence most common lesions encountered were in the categories of soft tissue benign neoplasms (35.1%) and soft tissue malignant neoplasms (21.8%). Remarkably, Burkitt’s lymphoma (BL) in the category of malignant soft tissue neoplasia constituted 11.8% of all the lesions biopsied while haemangiomas and tuberculous adenitis comprised 8.1% and 3.8% respectively. The age groups revealed the highest burden (37.1%) among the 0 to 5-year-olds followed by the 11 to 15-(34.5%) and 6 to 10-year-olds (28.4%). The orofacial site distribution among the 211 biopsied cases included 62.1% in the mandibular 29.9% in the maxillary region and 8% in the tongue areas. Malignant neoplasms of the bone were rare and all were diagnosed in the mandible. Overall, malignant neoplasms of soft tissue were significantly more in the age group of 6 - 10 years as well as in males than females. On the other hand, significantly more benign soft tissue neoplasms occurred in females than in males. Main Outcome Measure: There is great diversity and preponderance of soft tissue than skeletal orofacial lesions on the present audit. Significantly, clinicians should maintain high index of suspicion regarding the remarkably high frequency of diagnosing BL and tuberculous lymphadenitis in such a population in this era of HIV infection/AIDS.

关键词： Orofacial Neoplasm Soft Tissue Tuberculous lymphadenitis Lesion Children Burkitt Lymphoma Cross-Sectional Study Tanzania

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An atypical presentation of Kikuchi-Fujimoto disease mimicking systemic lupus erythematosus: case report and literature review

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Open Journal of Pediatrics 2011年第4期1卷 67-71页

作者： Diane Belder-Preston Catherine-Maude Pound Roman Jurencak 不详

Purpose: To report a case of atypical Kikuchi-Fujimoto disease (KFD) that illustrates several overlapping features with systemic lupus erythematosus (SLE). Methods: A case is reported followed by a review of the current literature. Case report: A 16-year-old boy with an unusual manifestation of Kikuchi-Fujimoto disease (KFD) is described. The patient presented with fever, weight loss and severe abdominal pain, due to extensive necrotizing retroperitoneal and mesenteric lymphadenopathy. During the course of his illness, he developed several symptoms suggestive of systemic lupus erythematosus (SLE): a pericardial effusion, cotton wool spots on the retina and antibodies against nuclear antigens (ANA), Smith (Sm) and ribonucleoprotein (RNP) antigens. However, no additional features of SLE were found. The patient subsequently fully recovered within two months, without initiation of immunosuppressive therapy. His autoantibodies became negative five months after initial presentation and he remains well at his 23 month follow up visit. Discussion: We hypothesize that the autoantibodies developed by our patient were secondary to self-antigen induced autoimmunity related to his extensive tissue necrosis. Despite initially having clinical features suggestive of SLE, our patient’s full and spontaneous recovery strongly supports the diagnosis of KFD. This illustrates the need for careful diagnosis, in order to avoid unnecessary and potentially toxic treatment with immunosuppressive agents.

关键词： Kikuchi-Fujimoto’s Disease Retroperitoneal lymphadenitis Systemic Lupus Erythematosus (SLE) Antinuclear Antibodies (ANA)

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