Fine needle aspiration cytology in systemic lupus erythematosus lymphadenopathy - A case report

BACKGROUND: Systemic lupus erythematosus (SLE) is an autoimmune disease of unknown etiology characterized by inflammation in various organ systems, in cluding lymph nodes, due to the production of antinuclear antibodies. The o nset of disease is between ages 13 and 40 years, with a female preponderanc e. CASE: A 30-year-old female presented with right cervical lymphadenopathy an d gave a history of intermittent fever and swollen joints of 2.5 years' dur ation. The patient was on intermittent corticosteroids. With a suggestion o f tuberculous lymphadenitis, the patient underwent fine needle aspiration ( FNA). The diagnosis of lupus adenopathy was established by FNA of enlarged right cervical lymph nodes. Smears showed predominantly typical and atypica l immunoblasts, plasma cells, occasional Reed-Sternberg-like cells and disp ersed hematoxylin bodies. Smears were negative for acid-fast bacilli. CONCLUSION: When SLE patients develop lymphadenopathy, FNA cytology helps d ifferentiate lupus adenopathy from infectious conditions, such as tuberculo us adenitis, and from Kikuchi's lymphadenitis.