Distinct Distribution of Immunocytes in a Retropharyngeal Lymphadenopathy Associated with Kawasaki Disease: A Case Study Compared with Tonsillitis.

Abstract:

OBJECTIVES:Retropharyngeal lesions are often associated with Kawasaki disease (KD). A 4-year-old male first presented a peritonsillar and retropharyngeal abscess-like lesion. Surgical tonsillectomy was performed to avoid a risk of mediastinal abscess, but he fulfilled the diagnostic criteria of KD after the operation. This prompted us to perform a histological study on the KD tonsils. METHODS:The histopathology of the KD tonsil specimens were compared with hypertrophic tonsils obtained from 4 patients with chronic tonsillitis unrelated to KD assessed by the immunostainings. RESULTS:KD tonsils showed small lymphatic follicles and neutrophil infiltration in the peritonsillar muscle layer, with no evidence of vasculitis or abscess formation. The KD tonsils exclusively showed (1) predominant activated CD4+ T cells in the perifollicular interstitium, (2) sparse scattering of CD68+ monocytes/macrophages in the lymphatic follicles, and (3) polyclonal carcinoembryonic antigen-positive cells in the lymphatic follicles and venules with the high endothelial cells. CONCLUSIONS:The uniquely distributed immunocytes suggest the inflammatory process of KD involving the pathogen-associated molecules.

journal_name

Cardiology

journal_title

Cardiology

authors

Okada S,Kobayashi-Fujiwara Y,Oga A,Furuta T,Ikemoto K,Fujii H,Sakata Y,Suzuki Y,Hasegawa S,Kusuda T,Itoh H,Yamashita H,Ohga S

doi

10.1159/000467388

subject

Has Abstract

pub_date

2017-01-01 00:00:00

pages

237-243

issue

4

eissn

0008-6312

issn

1421-9751

pii

000467388

journal_volume

137

pub_type

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