Lymph Node: Practice Question

Which of the following histologic feature favors a diagnosis of systemic lupus lymphadenopathy over Kikuchi lymphadenitis?
  1. Hematoxylin bodies
  2. Apoptosis and karyorrhexis
  3. Necrosis
  4. Non-necrotizing epithelioid granulomas
  5. Architectural distortion
Show Answer and Explanations

Hematoxylin bodies — Correct answer

Correct. Hematoxylin bodies are basophilic materials seen within areas of necrosis. They are composed of aggregates of nuclear DNA, and are found in lupus lymphadenitis.

Apoptosis and karyorrhexis

Incorrect. Apoptosis and karyorrhexis are seen in both conditions.

Necrosis

Incorrect. Necrosis is seen in both conditions.

Non-necrotizing epithelioid granulomas

Incorrect. Non-necrotizing epithelioid granulomas are not a feature of both conditions. They are usually seen in association with sarcoidosis.

Architectural distortion

Incorrect. Lymph node architecture may be distorted in both conditions.

Summary

Summary: There is histological overlap between lupus lymphadenitis and Kikuchi lymphadenitis; both share foci of necrosis, apoptosis, and karyorrhexis. However, the presence of hematoxylin bodies is a specific feature of lupus lymphadenitis in the proper clinical setting.
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