Kikuchi-Fujimoto disease: a rare but important differential diagnosis for lymphadenopathy

BMJ Case Rep. 2014 Sep 8:2014:bcr2014205470. doi: 10.1136/bcr-2014-205470.

Abstract

A 23-year-old man presented with a 6-week history of fevers, cervical lymphadenopathy and fatigue. A CT of the neck, chest, abdomen and pelvis showed left cervical lymphadenopathy, enlarged lymph nodes in the axilla and groin and hepatomegaly. A left cervical excisional lymph node biopsy was undertaken and the histopathological findings were consistent with Kikuchi-Fujimoto disease. He was treated with high-dose prednisolone for 1 week, which was then tapered. Generalised arthralgia and daily episodes of malaise were experienced for a subsequent 2 months following the cessation of corticosteroids. The condition lasted 4 months from the onset of symptoms. This case report highlights the importance of including Kikuchi-Fujimoto disease as a differential diagnosis for lymphadenopathy. Kikuchi-Fujimoto disease has commonly been mistaken for tuberculosis and lymphoma, and unnecessary exposure to agents used to treat these conditions can be avoided by prompt histological diagnosis.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Biopsy
  • Diagnosis, Differential
  • Glucocorticoids / therapeutic use
  • Histiocytic Necrotizing Lymphadenitis / diagnosis*
  • Histiocytic Necrotizing Lymphadenitis / drug therapy
  • Histiocytic Necrotizing Lymphadenitis / pathology
  • Humans
  • Lymph Nodes / pathology*
  • Lymphatic Diseases
  • Male
  • Neck
  • Prednisolone / therapeutic use
  • Young Adult

Substances

  • Glucocorticoids
  • Prednisolone