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

Seigo Okada, Yuki Kobayashi-Fujiwara, Atsunori Oga, Takashi Furuta, Kenzo Ikemoto, Hironori Fujii, Yasufumi Sakata, Yasuo Suzuki, Shunji Hasegawa, Takeshi Kusuda, Hiroshi Itoh, Hiroshi Yamashita, Shouichi Ohga

Research output: Contribution to journalArticle

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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: Thehistopathology 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.

Original languageEnglish
Pages (from-to)237-243
Number of pages7
JournalCardiology (Switzerland)
Volume137
Issue number4
DOIs
Publication statusPublished - Jul 1 2017

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine
  • Pharmacology (medical)

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