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- 저자 : 곽승민(Sueng Min Kwak) (검색결과 1 건)
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한지숙(Jee Sook Hahn),곽승민(Sueng Min Kwak),이선주(Sun Ju Lee),김응(Eung Kim),고윤웅(Yun Woong Ko) 대한내과학회 1989 대한내과학회지 Vol.36 No.5
N/A Subacute necrotizing lymphadenitis (SNL), first de- scribed in 1972 by Kikuchi, is characterized by benign cervical lymphadenopathy of unknown etiology with unique histologic features in young female patients. We reviewed the clinical features of 35 cases with SNL at Yonsei Medical Center from January 1980 to September 1987. The results obtained were as follows: 1) The median age was 27 years (range: 9~73 years) and the male to female ratio was 1:4, with 19 females (54 %) under 30 years. 2) The common chief complaints were neck mass (89 %) and fever (49%), and the duration of symptoms was generally less than 4 weeks, Cervical lymphadenopathy was noted in all cases. However, hepatosplenomegaly was not observed. The tentative diagnoses were tuberculous lymphadenitis in 7, fever of unknwon origin in 5, lymphoma in 2 and cervical lymphadenopathy in the remaining 21. 3) Lymph node enlargement was limited to the cervical area in most cases (91%). In addition to the cervical area, the axillary and inguinal area lymph nodes were also affected in 3 cases. The involved lymph nodes were multiple, small sized and often tender in character. 4) Leukopenia (47%), neutropenia (40%) and relative lymphocytosis (30%) were the relatively common hematologic abnormalities, while elevation of ESR (71 %) and LDH (54%) and a positive reaction for CRP (60 %) were also frequently seen. 5) No specific treatment was given in 21 cases and the median duration of fever was 20 days (mean: 34 days) in 17 febrile cases. 6) Systemic lupus erythematosis was confirmed in 1 case and strongly suspected in another case after diagnosis of SNL. In conclusion, a biopsy for cervical lymphadenopathy in young women with fever suggestive of SNL should be done in Koresa to exclude tuberculous lymphadenitis. A thorough examination by an experienced pathologist for the differential diagnosis with malignant lymphoma is recommended and furthemore, meticulous clinical follow-up is emphasized.
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