CYTOLOGIC FEATURES OF NECROTIZING GRANULOMATOUS INFLAMMATION CONSISTENT WITH CAT-SCRATCH DISEASE

Approximately 2,000 cases of cat-scratch disease are reported annually . It is an uncommon cause of unilateral lymphadenopathy in children an d adults. We present the cytologic features of necrotizing granulomato us lesions consistent with cat-scratch disease from various sites. Ele ven cases from 10 patients with a mean age of 16 yr (range, 2-33 yr) w ere biopsied by fine-needle aspiration. All gave a history of previous exposure to cats. Two children had atypical presentations; one with m ultiple hypodense areas within the liver and spleen, and the other wit h features of encephalitis. Other locations included lymph nodes from axilla, inguinal, preauricular, and cervical areas, and other body sir es such as the scapula and the parotid gland. Histologic staging of th e inflammatory process was correlated with cytologic features. There w ere 5 cases of early features, 3 cases in the middle phase, and 3 case s in late stage. The differential diagnosis of each stage is discussed . The 2 children with atypical presentations are described in detail. (C) 1996 Wiley-Liss, Inc.