Kikuchi-Fujimoto disease: a case report and the evaluation of diagnostic procedures

Abstract

Background: Kikuchi-Fujimoto disease, known as histiocytic necrotizing lymphadenitis, is a benign, self-limiting and systemic disorder involving lymph nodes with unknown aetiology. First reported in Japan, there has been an increase in its incidence globally. Because of its non-specific clinical features, the disease can be easily mistaken for other forms of lymphadenitis with a high rate of misdiagnosis and mistreatment, posing a considerable challenge. Case presentation: A case of young Chinese woman with fever and cervical lymphadenopathy is presented. Physical examinations and imaging techniques were used to rule out common forms of lymphadenitis (e.g. cat-scratch disease and tuberculous lymphadenitis). Laboratory tests were then conducted to exclude others such as systemic lupus erythematosus and non-Hodgkin lymphoma. After Kikuchi-Fujimoto disease was identified, the patient was managed with symptomatic treatments. Our case was compared with relevant cases in the literature. A diagnostic flow chart was proposed to facilitate the diagnosis and treatment. Conclusions: With its shared clinical features, Kikuchi-Fujimoto disease can be mistaken for other forms of lymphadenitis. A combined use of medical imaging and laboratory tests is the effective way to avoid misdiagnosis.

Kikuchi disease: A Case Report from Himachal Pradesh

“…: Tuberculosis, Cat Scratch Disease) or associated with other disorders like SLE, sarcoidosis & viral lymphadenitis. 5 Diagnosis of Kikuchi's disease is confirmed by histopathological examination of biopsied specimen of lymph node; Three types of findings are identified: proliferative, necrotizing and xanthomatous. The proliferative features are seen in one-third of cases with an inflammatory infiltrate; half ofcases show necrotizing pattern and rare xanthomatous type; with abundant foam cells.…”

“…Since similar symptoms are noted in diseases such as lymphomas, an accurate diagnosis & thereby treatment is essential and to be kept in mind. 5 The involvement of mediastinal, peritoneal, and retroperitoneal regions are uncommon. Extranodal involvement of Kikuchi disease is rare; has been documented in the skin, bone marrow, myocardium, & central nervous system.…”

“…7,9,11 Useful tests include ruling out Tuberculosis, Warthin Starry staining for Bartonella, and hematoxylin bodies along with other tests for SLE. 5 Generally KFD is a benign, self-limiting disorder, so a short inpatient stay with symptomatic treatment generally suffices; but patients with significant systemic symptoms may need appropriate drugs, hormones & immunosuppressants to manage and assist recovery. 5…”

“…5 Generally KFD is a benign, self-limiting disorder, so a short inpatient stay with symptomatic treatment generally suffices; but patients with significant systemic symptoms may need appropriate drugs, hormones & immunosuppressants to manage and assist recovery. 5…”

Kikuchi-Fujimoto disease: State of the art

“…Therefore, the practicing physician should remember about KFD in patients with cervical lymphadenopathy, who have recently returned from a trip to Asia. 2,4,5 Due to the lack of pathognomonic clinical symptoms, about 40% of KFD cases are confused with other diseases involving lymphadenitis. 5…”