Histiocytic necrotizing lymphadenitis in children: A clinical and immunohistochemical comparative study with adult patients

ObjectivesLimited information is available regarding the characteristics of histiocytic necrotizing lymphadenitis (HNL) in children. This study compares the clinical and laboratory features as well as the immunohistochemical findings of HNL in children with those of adults.Study designRetrospective analysis.MethodsThirty patients who underwent a biopsy of a cervical lymph node and were histologically proven to have HNL were enrolled in this study. There were 13 children and 17 adults. CD68, CD163 and myeloperoxidase expression were analyzed by immunohistochemical staining.ResultsChildren had more bilateral lymphadenopathy (P = 0.045) and a higher expression of CD68 (P = 0.043) than did the adult patients. However, there was no significant difference between the groups in the following variables: patient gender, presence of fever, size and necrosis of enlarged lymph node, multiplicity of lymphadenopathy, WBC count, ESR, CRP, recurrence, and expression of myeloperoxidase and CD163.ConclusionsThe clinical and immunohistological characteristics of HNL in pediatric patients are similar to those of adults. Bilateral involvement of lymph nodes and a high expression of CD68 were the only features significantly associated with children with HNL.