Differential Diagnosis of Histiocytic Necrotizing Lymphadenitis and Malignant Lymphoma with Simple Clinical Findings

• Published in: Children (Basel) Vol. 9; no. 2; p. 290
• Main Authors: Omachi, Taichi, Atsumi, Naho, Yamazoe, Takashi, Yamanouchi, Sohsaku, Matsuno, Ryosuke, Kitawaki, Tomoki, Kaneko, Kazunari
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 20.02.2022; MDPI
• Subjects: Autoimmune diseases; Biopsy; Blood; Body temperature; Cytomegalovirus; Epstein-Barr virus; Fever; Herpes viruses; Kawasaki disease; Laboratories; lymphadenitis; Lymphatic diseases; Lymphocytes; Lymphoma; maximum lymph node size; Medical diagnosis; Medical records; Neutrophils; Pediatrics; Serology; Viral infections; β2-microglobulin; maximum lymph node size; body temperature; β2-microglobulin; lymphadenitis
• ISSN: 2227-9067; 2227-9067
• DOI: 10.3390/children9020290

It is desirable that noninvasive differential diagnosis takes place without lymph node biopsy for histiocytic necrotizing lymphadenitis (HNL) or malignant lymphoma (ML). In this study, we propose a novel scoring model for the differential diagnosis of these diseases using clinical information and clinical findings. We retrospectively analyzed the data from 15 HNL and 13 ML pediatric patients. First, a univariate analysis identified 14 clinical factors with significant differences. Second, a subsequent analysis using receiver operating characteristic (ROC) curve analysis identified three factors among them with area under the ROC curve values of >0.95: body temperature (°C), maximum lymph node size (cm), and serum β -microglobulin level (mg/L). Finally, the cut-off values of each of these three factors were determined and examined for the 28 cases. All 15 HNL cases were within 2-3 of the cut-off values among the three factors, no ML case was within two or more cut-off values. Thus, the diagnostic sensitivity and specificity of this novel scoring system were both 100%, indicating that clinical scoring with body temperature, maximum lymph node size, and β -microglobulin are useful for distinguishing between HNL and ML.