[Involvement of the intraabdominal lymph nodes in a case of subacute necrotizing lymphadenitis].

A 40-year-old woman was admitted to our hospital because of fever, polyposia and polyuria in October 1990. The fasting blood sugar level was 471mg/dl and abdominal CT showed enlargement of the liver, kidneys, and intraabdominal lymph nodes. Although severe diabetes mellitus was controlled with insulin, intraabdominal lymph node swelling continued. Lymph node biopsy was performed under laparotomy. Four from intraabdominal lymph nodes, in addition to one from the left axillary lymph nodes. Four showed findings of non specific lymphadenitis, but one specimen obtained from near the right kidney demonstrated focal necrosis and invasion of macrophages and immunoblasts, which were compatible with the features of subacute necrotizing lymphadenitis (SANL). In SANL, lymphadenopathy is usually observed in the cervical region of young female and the involvement of intraabdominal lymph nodes is quite rare. This patient is the second case of SANL involving an intraabdominal lymph node reported in Japan, and it is suggested that SANL should be considered as a causative disorder of intraabdominal lymphadenopathy.