目的:报道急性白血病患者Kikuchi病的临床病理特征,强调案件之间的相似性。
结果:在454名菊池病患者的队列中,我们发现3例并发急性白血病.这些患者具有相似的临床特征,Kikuchi病在诱导化疗开始后大约一个月出现,以颈部淋巴结肿大为特征。值得注意的是,两名患者是中年人,偏离了菊池病的典型年龄分布。组织学上,这些病例与典型的Kikuchi病一致。免疫组织化学染色阴性(CD34,CD117,ERG,TdT)表明没有髓外白血病浸润。单纯疱疹病毒免疫组织化学染色也为阴性。重要的是,在这3例病例中观察到人类白细胞抗原(HLA)相关性.HLA-B*15:01,C*04:01和DRB1*04:06在这些患者中与普通人群相比更为普遍(与三个独立的对照组相比:台湾汉族(n=504),慈济台湾骨髓捐献者(n=364)和香港中国人(n=5266))。
结论:我们的研究强调了Kikuchi病和急性白血病之间的独特联系,以特定特征和HLA关联为特征。这强调了Kikuchi疾病在相关临床情况下可能的鉴别诊断。此外,这种综合征提供了对急性白血病化疗后免疫学的见解,增强理解力。
OBJECTIVE: To report the clinicopathological features of Kikuchi disease in patients with acute leukaemia, emphasising similarities among cases.
RESULTS: In a cohort of 454 Kikuchi disease patients, we identified three cases of concurrent acute leukaemia. These patients shared similar clinical traits, with Kikuchi disease emerging approximately a month after induction chemotherapy onset, featuring neck-region lymphadenopathy. Notably, two patients were middle-aged, deviating from the typical age distribution of Kikuchi disease. Histologically, these cases aligned with typical Kikuchi disease. Negative immunohistochemical stains (CD34, CD117, ERG, TdT) indicated the absence of extramedullary leukaemic infiltration. Herpes simplex virus immunohistochemical staining was also negative. Significantly, a human leucocyte antigen (HLA) association was observed in these three cases. HLA-B*15:01, C*04:01, and DRB1*04:06 were more prevalent in these patients compared to the general population (compared with three independent control cohorts: Taiwanese Han Chinese (n = 504), Tzu Chi Taiwanese bone marrow donors (n = 364) and Hong Kong Chinese (n = 5266)).
CONCLUSIONS: Our study underscores the unique link between Kikuchi disease and acute leukaemia, characterised by specific features and HLA associations. This underlines Kikuchi disease as a possible differential diagnosis in pertinent clinical scenarios. Furthermore, this syndrome offers insights into postchemotherapy immunology in acute leukaemia, enhancing comprehension.