SUBACUTE NECROTISING LYMPHADENITIS:A Clinicopathologic Study

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Abstract
This report describes the clinical and pathologic findings of 21 patients with subacute necrotizing lymphadenitis (N.L.). Clinical features of all but 2 patients were as typically described in the literature; young age, enlargement of cervical or axillary lymph nodes, slight to moderate fever with poor response to antibiotics, and invariable spontaneous resolution. Two patients showed atypical clinical findings; remittent high fever with profound prostration in both patients, generalized lymphadenopathy in one, and being a Caucasian in the other. Systemic symptoms resolved gradually, and both patients are now doing well. One patient, however, underwent a staging laparotomy due to a misdiagnosis as unclassiflable lymphoma of the lymph node biopsy. Biopsies of the lymph nodes from all patients demonstrated the typical pathologic features of NL.; i.e., an intensive proliferation of activated lymphocytes mottled by necrotic foci in which polymorphonuclear leukocytes were characteristically absent. Bacteriologic and serologic studies were negative. We conclude that some patients with N.L. run a protracted course with remittent high fever before spontaneous resolution and that a correct pathologic diagnosis helps precluding unnecessary diagnostic or therapeutic measures on such patients.

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