Clinical Analysis of 44 Children with Subacute Necrotizing Lymphadenitis

OBJECTIVE: To explore the causes, clinical features, and laboratory examination characteristics of subacute necrotizing lymphadenitis to improve the understanding of this disease, reduce misdiagnosis, and make appropriate diagnoses and treatments. METHODS: The clinical data of 44 children with subacute necrotizing lymphadenitis admitted to our hospital from January 2013 to August 2021 were collected. The clinical and laboratory examinations of the disease were systematically analyzed. RESULTS: All 44 cases aged 6–13 years and averaged 10.3 ± 2.1 years, including 32 boys and 12 girls, were diagnosed with histiocytic necrotizing lymphadenitis (HNL) by lymph node biopsy. Forty-two cases had palpable superficial lymph nodes, and two showed abdominal lymph node enlargement in the imaging examination. The symptoms might be accompanied by mild hepatomegaly or splenomegaly, emaciation, night sweats, rashes, and other manifestations. Leukopenia and neutropenia occurred. The pathological features were extensive coagulative necrosis of lymph nodes with reactive hyperplasia of histiocytes as well as positive IHCl CD68. Four cases had a relapse, and the prognosis of the other cases was good. CONCLUSION: The case with fever and lymph node enlargement of unknown origin and no response to antibiotic treatment should undergo a pathological examination as early as possible for diagnosis and treatment. The disease has a good prognosis in most cases but may recur in a few cases.