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nodal Kawasaki disease

Monday 9 January 2006

Definition: lymph node lesions in Kawasaki disease.

Synopsis

- multiple foci of necrosis (#7149090#)
- fibrin thrombi within the microvasculature (#7149090#)

Most lymphadenopathy is non-specific, caused by sinus expansion and paracortical zone enlargement, but there are also necrotic lesions of various sizes that can be surmised to result from ischaemic changes in some LNs.

Necrotic foci start to develop immediately below the capsule, and are accompanied by fibrin thrombi in the small vessels and perivascular nuclear debris.

Especially in the case of cervical LNs with necrosis, a high degree of non-purulent inflammation develops in the LN capsule and surrounding connective tissue.

In addition to lymphadenopathy with necrosis, KD should be suspected if there is non-purulent inflammation of the LN capsule and/or surrounding connective tissue featuring mainly monocytes/macrophages.

References

- Histopathological study of lymph node lesions in the acute phase of Kawasaki disease. Yokouchi Y, Oharaseki T, Harada M, Ihara F, Naoe S, Takahashi K. Histopathology. 2012 Jul 27. doi: 10.1111/his.12007 . PMID: #23020240#

- Giesker DW, Pastuszak WT, Forouhar FA, Krause PJ, Hine P. Lymph node biopsy for early diagnosis in Kawasaki disease. Am J Surg Pathol. 1982 Sep;6(6):493-501. PMID: #7149090#