Kedi Tırmığı Hastalığı Lenfadeniti
Özet
Kedi tırmığı hastalığı (KTH), en sık Bartonella henselae etkenine bağlı gelişen, özellikle çocuklar ve genç erişkinlerde görülen zoonotik bir enfeksiyondur. Hastalık çoğunlukla bölgesel lenfadenopati ile seyretmekte olup, histopatolojik olarak süpüratif granülomatöz inflamasyon ve karakteristik stellat nekroz alanları ile tanınmaktadır. Bu bölümde KTH’nin epidemiyolojisi, etyopatogenezi, klinik bulguları ve güncel tanısal yaklaşımları ele alınmıştır. Lenf nodu biyopsilerinde görülen histopatolojik evreler ayrıntılı olarak açıklanmış; foliküler hiperplaziden nekrotizan granülom oluşumuna kadar uzanan morfolojik değişiklikler değerlendirilmiştir. Ayrıca Warthin–Starry boyama, immünohistokimya ve moleküler yöntemlerin tanısal değeri özetlenmiştir. KTH’nin tüberküloz lenfadeniti, sarkoidoz, Kikuchi hastalığı ve lenfomalar gibi granülomatöz veya neoplastik lenfadenopatilerden ayırıcı tanısı üzerinde durulmuştur. Bölüm, patologlar ve klinisyenler için KTH’nin morfolojik özellikleri ile modern tanısal yöntemlerini bütüncül şekilde sunmayı amaçlamaktadır.
Cat scratch disease (CSD) is a zoonotic infection predominantly caused by Bartonella henselae and commonly affects children and young adults. It typically presents with regional lymphadenopathy and is histopathologically characterized by suppurative granulomatous inflammation and stellate necrosis. This chapter reviews the epidemiology, etiopathogenesis, clinical manifestations, and contemporary diagnostic approaches of CSD. Histopathological changes observed in lymph node biopsies are discussed in detail, including the progression from follicular hyperplasia to necrotizing granuloma formation. The diagnostic utility of Warthin–Starry staining, immunohistochemistry, and molecular methods is also summarized. Furthermore, differential diagnosis with other granulomatous and neoplastic lymphadenopathies, including tuberculosis, sarcoidosis, Kikuchi disease, and lymphomas, is emphasized. This chapter aims to provide an integrated overview of the morphologic features and modern diagnostic strategies of CSD for pathologists and clinicians involved in the evaluation of granulomatous lymphadenitis.
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