Diagnosis of Kikuchi-Fujimoto disease: a comparison between open biopsy and minimally invasive ultrasound-guided core biopsy.

Shan-Chi Yu,Chun-Nan Chen,Tseng-Cheng Chen,Tsung-Lin Yang,Cheng-Ping Wang,Pei-Jen Lou,Hsin-I Huang,Tzu-Yu Hsiao,Jenq-Yuh Ko,Syed A Aziz

doi:10.1371/journal.pone.0095886

Shan-Chi Yu, Chun-Nan Chen + Show 8 more

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https://doi.org/10.1371/journal.pone.0095886

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Abstract

Kikuchi-Fujimoto disease (KFD) is a self-limited disease without any need of surgical treatments. Sampling of tissue is the only invasive procedure during the clinical course. However, the standard sampling procedure with accuracy, minimal invasiveness, and esthetic maintenance has not been established yet. In this study, a retrospective review of clinical utility and pathological presentations of the ultrasound-guided core biopsy (USCB) and the open biopsy (OB) in consecutive KFD patients. From 2010 to 2012, 34 consecutive patients were enrolled. USCB was performed in 11 patients, and OB was done in 26 patients. KFD was confirmed in 82% cases by USCB. Similar pathological presentations were found both in the specimens of USCB and OB. In the three patients who had received both USCB and OB, KFD was confirmed by USCB in one case, while two by OB. Sampling errors were found both in USCB and OB. For diagnosing KFD, USCB can serve as the first-line diagnostic tool. OB can be applied only in the failed cases of USCB.

Highlights

Kikuchi-Fujimoto disease (KFD), known as histiocytic necrotizing lymphadenitis, is a reactive disease
We aimed to evaluate the clinical utility and pathological findings of ultrasound-guided core biopsy (USCB) and open biopsy (OB) in diagnosing KFD
In this study, we demonstrated that KFD could be diagnosed either by USCB or OB

Summary

Introduction

Kikuchi-Fujimoto disease (KFD), known as histiocytic necrotizing lymphadenitis, is a reactive disease. The pathogenesis remains unknown, the clinical and pathological features of KFD had been described in several series [1,2,3]. Most KFD patients recover without any treatments. A biopsy for tissue proof is the most invasive procedure during clinical courses. The open biopsy (OB) is routinely used as a standard method to harvest specimens. OB is invasive, and sometimes needs general anesthesia and hospital care [7]. Scars are left on the neck, which deteriorate cosmetic outcomes. Because of these clinical drawbacks, to develop an alternative sampling method with minimal invasiveness is required. Surgical interventions are not necessary if the specimens are sufficient to confirm the diagnosis

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