Spontaneous regression of Kikuchi lymphadenopathy with oligoclonal T-cell populations favors a benign immune reaction over a T-cell lymphoma
Journal
American Journal of Clinical Pathology
Journal Volume
117
Journal Issue
4
Pages
627-635
Date Issued
2002
Author(s)
Abstract
To aid in the initial diagnosis of Kikuchi lymphadenitis and to assess whether the composition of the T cells might shed light on the pathogenesis, we used nested polymerase chain reaction tests followed by high-resolution gel electrophoresis to determine the pattern of T-cell antigen receptor rearrangement in 56 consecutive cases. Except for 1 unusual case with recurrent lymphadenopathy, none had a monoclonal beta or gamma rearrangement. Eight cases had a polyclonal pattern at both beta and gamma loci, 20 cases had a mixed polyclonal beta and oligoclonal gamma pattern, and 27 cases had an oligoclonal pattern at both loci. The high frequency of oligoclonality did not indicate an early-stage T-cell lymphoma in evolution, as confirmed by spontaneous resolution of the lymphadenopathy in all cases within 6 months. Rather, it is consistent with reports of oligoclonal T cells in a variety of immune reactions. We conclude that, in the vast majority of cases, absence of a monoclonal T-cell receptor rearrangement excludes the possibility of T-cell lymphoma, and the presence of an oligoclonal pattern implies a benign immune reaction.
SDGs
Other Subjects
T lymphocyte receptor; T lymphocyte receptor beta chain; T lymphocyte receptor gamma chain; article; clonogenesis; controlled study; gene rearrangement; histopathology; human; human tissue; immunopathogenesis; Kikuchi disease; major clinical study; polymerase chain reaction; priority journal; T cell lymphoma; T lymphocyte; T lymphocyte receptor gene; Adolescent; Adult; Child; DNA Primers; Electrophoresis; Female; Gene Rearrangement, beta-Chain T-Cell Antigen Receptor; Gene Rearrangement, gamma-Chain T-Cell Antigen Receptor; Gene Rearrangement, T-Lymphocyte; Histiocytic Necrotizing Lymphadenitis; Humans; Lymphoma, T-Cell; Male; Middle Aged; Polymerase Chain Reaction
Type
journal article