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(American Journal of Pathology. 2001;159:915-924.)
© 2001 American Society for Investigative Pathology

Regular Articles

Myeloperoxidase Expression by Histiocytes in Kikuchi’s and Kikuchi-Like Lymphadenopathy

Stefano A. Pileri^*, Fabio Facchetti, Stefano Ascani^*, Elena Sabattini^*, Simonetta Poggi^*, Milena Piccioli^*, Damiano Rondelli^*, Federica Vergoni, Pier Luigi Zinzani^*, Pier Paolo Piccaluga^*, Brunangelo Falini and Peter G. Isaacson

From the Pathology and Clinical Units,^*
Institute of Hematology and Clinical Oncology "L. & A. Seràgnoli," Bologna University, Bologna, Italy; the Institute of Pathologic Anatomy and Histopathology,
Brescia University, Brescia, Italy; the Hematopathology Laboratory,
Institute of Hematology, Perugia University, Perugia, Italy; and the Histopathology Department,
University College London, London, United Kingdom

Forty-five examples of Kikuchi’s lymphadenitis (KL), 5 Kikuchi-like lupus erythematosus lymphadenopathies, 25 nonnecrotizing lymphadenitidies (5 toxoplasmic, 5 sarcoid-like, 6 dermatopathic, 4 suppurative, 3 tubercular, 2 with sinus histiocytosis), 4 examples of hyaline-vascular Castleman disease (CD), 2 plasmacytoid monocyte tumors (PM-Ts), and 61 accessory cell neoplasms were studied by a panel of antibodies, including the PG-M1 (against a macrophage-restricted CD68 epitope) and a polyclonal anti-myeloperoxidase (MPO). In KL and Kikuchi-like lupus erythematosus lymphadenopathies, 25 to 75% of CD68⁺ histiocytes co-expressed MPO. This did not occur in nonnecrotizing lymphadenitidies and accessory cell neoplasms. MPO⁺/CD68⁺ elements corresponded to nonphagocytosing mononuclear cells and some crescentic macrophages and phagocytosing histiocytes. Typical PMs were MPO^-/CD68⁺ in all cases, including CD and PM-T. Our observations suggest that in KL and KL-like lymphadenopathies: 1) MPO⁺/CD68⁺ blood monocytes might be attracted into tissues because of the lack or paucity of granulocytes and the need of MPO for oxidative processes; 2) PMs are more likely to be involved in the cytotoxic immune reaction than in phagocytic phenomena; 3) the peculiar phenotype of the histiocytic component can be usefully used for the differentiation from malignant lymphoma and PM-T.

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