Two cases of histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto's disease) following diffuse large B-cell lymphoma

Histiocytic necrotizing lymphadenitis (HNL) is often mistaken for malignant lymphoma clinically and is also sometimes difficult to differentiate from lymphoma even histopathologically, In this report, we describe the first 2 reported cases of HNL following non-Hodgkin's lymphomas, The patients were 27- and 30-year-old women who developed cervical and axillary lymph node sw ellings, respectively, in the course of remission of diffuse large B-cell l ymphoma. The affected lymph nodes showed the typical histology of HNL: ;irr egular-shaped "necrotic" foci with histiocytes engulfing apoptotic bodies i ntermingled with large-sized blastic lymphocytes, These finding mimicked th e partial involvement of large-cell lymphoma. However, the blastic cells we re almost exclusively T cells, and numerous apoptotic bodies were present, which excluded the possibility of recurrence of diffuse large B-cell lympho ma. HUM PATHOL 31:1328-1331. Copyright (C) 2000 by W.B. Saunders Company.