Cervical Lymphadenopathy Showing Pathological Findings of Histiocytic Necrotizing Lymphadenitis (HNL) in a Patient with Systemic Lupus Erythematosus (SLE)

We report 26-year-old female whose cervical lymph node became swollen, accompanied by aggravation of systemic lupus erythematosus (SLE) symptoms. Histologically, the lymph node showed necrosis with a geographic pattern, and increments in the macrophages and histiocytes preying upon the apoptotic lymphocytes. The clinical and pathological findings were consistent with histiocytic necrotizing lymphadenitis (HNL). Recently, however, it has been considered that histological finding of HNL in an SLE patient indicates that the lymphadenitis is related to SLE (lupus lymphadenitis). Thus, the present case was diagnosed as lupus lymphadenitis. Steroid administration to improve the SLE symptoms was also effective for lymphadenitis. The present case indicates that cervical lymphadenitis associated with an autoimmune disease, such as SLE, is occasionally difficult to differentiate from HNL, and suggests that treatment of the primary disease is important to improve disease-associated lymphadenitis.