a patient with Kawasaki disease Obliteration of nodal architecture with lymphocyte depletion Kawasaki disease is a medium-sized vessel vasculitis involving muscular arteries. Patients present with fever, conjunctiva and oral erythema and ulceration, edema and erythema of the hands and feet, skin rash with
desquamation, and enlargement of cervical lymph nodes. Biopsy of an involved cervical lymph node would show
obliteration of the nodal architecture ( choice D) with depletion of lymphocytes, loss of follicular centers, and
vascular proliferation with thrombi in small vessels. Small foci of necrosis not zonal necrosis (choice B) can be seen in both the interfollicular and follicular centers.