Diagnosing Kikuchi's disease on fine needle aspiration biopsy

Abstract

To investigate the diagnostic utility of fine needle aspiration (FNA) smear, cell block (CB), flow cytometry (FC) and tuberculosis polymerase chain reaction (Tb-PCR) analysis for Kikuchi's disease (KD). A total of 173 FNA biopsy samples were collected using a Youyi aspirator. KD was diagnosed by FNA smear, with or without, CB, FC and Tb-PCR. Out of 173 patients, 131 (75.7%) were female and 126 (72.8%) aged 21-40years. Of these, 171 patients (98.8%) presented with painful enlarged cervical lymph nodes. All cytological samples identified intracellular apoptotic debris embedded in the cytoplasm of crescentic and phagocytic macrophages. In 24 cell-blocks (CBs), clusters of CD123 positive plasmacytoid monocytes were observed in KD. FC and CBs showed non-specific lymphoid hyperplasia in nine cases with suspicious lymphoma. Tb-PCR was negative in five cases with suspicion of tuberculosis. In summary, FNA biopsy is a fast, reliable, and relatively inexpensive diagnosis tool for KD. CB preparation is an important adjunct method for the diagnosis of KD.