Title: Kikuchi’s Disease Presenting as Pyrexia of Unknown Origin: A Case Report & Literature Review
Authors: Dr Priya Sahu, Dr Ashish Nigam
DOI: https://dx.doi.org/10.18535/jmscr/v5i1.84
Abstract
We report this case of a 41 year old Indian male who presented as pyrexia of unknown origin along with weight loss and joint pain. The patient underwent extensive laboratory investigations with clinical suspicion of tubercular or viral etiologies; except for elevated ESR and mildly low leukocyte count all the laboratory investigations were normal. Radiological examinations showed generalized lymphadenopathy and hepatosplenomegaly. The final diagnosis was reached by histopathological examination of cervical lymph node, which showed necrotic foci with karyorrhectic and eosinophilic debris surrounded by lymphohistiocytic and mononuclear plasmacytoid cells which are characteristics of Kikuchi-Fujimoto disease (KFD), so-called histiocytic Necrotizing lymphadenitis.
Keywords: Kikuchi-Fujimoto disease, Histiocytic necrotizing lymphadenitis, Lymphadenopathy, Pyrexia of unknown origin.
References
1. Kuo T. Kikuchi's disease (histiocytic necrotising lymphadenitis): a clinicopath-ologic study of 79 cases with an analysis of histologic subtypes, immunohistology and DNA ploidy. Am J Surg Pathol 1995;19:798-809.
2. Menasce LP, Banerjee SS, Edmondson D, Harris M. Histiocytic necrotizing lympha-denitis (Kikuchi-Fujimoto disease): contin-uing diagnostic difficult-ies. Histopathology. 1998; 33 (3): 248-54
3. Kikuchi M. Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytes. Acta Hematol Jpn 1972; 35:379-80.
4. Fujimoto Y, Kozima Y, Yamaguchi K. Cervical subacute necrotizing lymphadenitis. A new clinicopathological entity. Naika 1972; 30:920-7
5. Thongsuksai P, Kayasut K. Histiocytic necrotizing lymphadenitis (Kikuchi’s disease): clinicopathologic characteristics of 23 cases and literature review. J Med Assoc Thai. 1999;82:812–818.
6. Madle-Samardzija N, Turkulov V, Vukadinov J, Stajnic S, Canak G. Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease). Med Pregl. 2000;53: 513–516.
7. Yabe H, Sinzato I, Hashimoto K. Necrotizing lymphadenitis presenting as mesenteric lymphadenopathy. Rinsho Ketsueki. 1999;40:658–662.
8. Hassan M, Anees A, Zaheer S. Kikuchi-Fujimoto disease: diagnostic dilemma and the role of immunohistochemistry. J Clin Med Res. 2009;1(4):244–246.
9. Kucukardali Y, Solmazgul E, Kunter E, Oncul O, Yildirim S, Kaplan M. Kikuchi-Fujimoto Disease: analysis of 244 cases. Clin Rheumatol. 2007;26(1):50–4. doi: 10.1007/s10067-006-0230-5.
10. Ramkumar A. Kikuchi-Fujimoto Disease as a Differential Diagnosis for Cervical Lymphadenopathy in India: A Case Report and Review of Literature. Indian Journal of Otolaryngology and Head & Neck Surgery. 2011;63(Suppl 1):110-112.