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Lymph node necrosis in systemic lupus erythematosus: A histopathological and immunohistochemical study of four cases

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The lymph node lesions of lupus lymphadenitis are characterized by necrosis sometimes accompanied by hematoxylin bodies, but only a few immunohistological analyses of this unique lesion have been reported. In this study we investigated the immunopathogenesis of these lesions. Lymph node specimens from four patients were analyzed immunohistochemically by applying recently developed monoclonal antibodies to immunocompetent cells. Necrosis occupied almost the entire lymph node in two cases (extensive type), whereas small foci of necrosis were found in the paracortex in the remaining two (localized type). No hematoxylin body formation was detected in any of the samples. Necrosis of the small muscular arteries, arterioles and venules was seen in the necrotic areas in all four cases. In one case of the localized type, necrotizing angitis was seen in a few arterioles and venules in the non-necrotic area. By immunohistology, amorphous depositions of immunoglobulins and C3 were demonstrated in the walls of the arterioles and venules in two cases. Our findings indicate that vasculitis due to local deposition of immune complexes in the blood vessels may play an important role in the pathogenesis of necrosis in lupus lymphadenitis.

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Keywords: Systemic lupus erythematosus; immune complex vasculitis; lymph node necrosis; necrotizing angitis

Document Type: Original Article

Affiliations: 1: Department of Pathology, Dokkyo University School of Medicine, Mibu, Japan, 2: Department of Pathology and Genetics, Aichi Cancer Center Hospital, Nagoya, Japan, 3: Department of Pathology and Clinical Laboratories, Maebashi Red Cross Hospital, Maebashi, Japan, 4: Department of Pathology and Clinical Laboratories, Kiryu Welfare General Hospital, Kiryu, Japan

Publication date: February 1, 2001

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