Abstract
A lady from Sudan was referred to our medical clinic as a case of cervical lymphadenopathy with gradual enlargement. She had no complaint. The cervical lymphadenopathy was not associated with pain, fever, weight loss, cough, neither bleeding nor other associated swellings. There was no history of chronic medical problems including TB and underwent thorough investigations including LN biopsy. Lymphoma was initially suspected. Fine-needle aspiration and excision biopsy were undertaken. Histological analysis later suggested Kikuchi-Fujimoto disease, also known as histiocytic necrotizing lymphadenitis. Kikuchi-Fujimoto disease (KFD) was described in 1972 as lymphadenitis with focal proliferation of reticular cells accompanied by numerous histiocytes and extensive nuclear debris. KFD, frequently found in East Asian countries, is rare in the UK. No definite etiology of KFD is known despite autoimmune and infection factors being suggested. The diagnostic hallmark is histological findings from lymph nodes. Steroid therapy could be used in severe cases. KFD is relatively unknown and this case report aims to highlight its occurrence in our population.
Highlights
Cervical lymphadenopathy can be caused by a wide range of conditions, from benign infectious diseases to malignant lymphomas
According to NICE guidelines, cervical lymphadenopathy persisting>3 weeks should be considered as cancer and referred to the ENT clinic
Kikuchi-Fujimoto disease (KFD) is prevalent in adult patients with the mean age of diagnosis around 21 preponderances of 4:1 with females.[2]
Summary
Cervical lymphadenopathy can be caused by a wide range of conditions, from benign infectious diseases to malignant lymphomas. This article reports a case of persistent tender cervical lymphadenopathy which had confounded diagnosis until a histological specimen was obtained from the lymph tissue which encased the internal carotid artery close to the base of skull It emerged that our patient had KFD, otherwise known as histiocytic necrotizing lymphadenitis. A female patient from Sudan who came to follow the result of biopsy of her lymph node was seen in the clinic as a case of cervical LNs with gradual enlargement. Excisional biopsy: Consistent with necrotizing histiocytic lymphadenitis (Kikuchi disease), based on the histological findings.
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