About a rare disease misdiagnosed as malignant lymphoma or tuberculosis: Kikuchi-Fujimoto’s disease

Lahma, Jawad; Arkoubi, Zakaria; Hejjouji, Reda; Sophia, Nitassi; Ayoubi, A. El; Bencheikh, Rachida Soulaymani; Benbouzid, Mohammed Anas; Oujilal, Abdelilah; Essakalli, Leila

doi:10.11604/pamj.2018.31.77.16569

Cited by 7 publications

(7 citation statements)

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“…Other unique presentations of KFD include splenomegaly, hepatomegaly, upper respiratory complaints, lethargy, gradual onset of pallor, arthralgia, cachexia, nausea, vomiting, diarrhea, and persistent fever [5,14,[22][23][24]. It is also noted that KFD has similarity and confusion with some autoimmune diseases such as SLE and some infectious diseases such as toxoplasma lymphadenitis, cat scratch disease, and tuberculosis [5,25].…”

Section: Discussionmentioning

confidence: 99%

Pathological Features and Clinical Characteristics of Kikuchi-Fujimoto Disease: A Tertiary Hospital Experience in Riyadh, Saudi Arabia

Alshieban

Masuadi

Alghamdi

et al. 2023

Cureus

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BackgroundKikuchi-Fujimoto disease (KFD) -also known as necrotizing histiocytic lymphadenitis -is a benign histiocytic lymphadenitis known for its low incidence and misdiagnosis that occurs mostly in young Asian females more than males. This disease resolves spontaneously in a few months with a low risk of relapse (one in 30 patients) after resolution. ObjectivesThe aim of this study is to share King Abdulaziz Medical City's (KAMC's) experience with KFD by determining its clinicopathological characteristics. Materials and methodsIn this study, we reviewed histopathological slides and pathological reports of all lymphadenopathy cases (683 cases) in the period between January 2008 and December 2018. ResultsForty-four cases of KFD were found and their clinicopathological characteristics were recorded. There is a slight female predominance (59% females versus 41% males) with a wide age range from 10 months to 97 years (mean = 28.8). The majority of the cases (63.6%) are seen in young adults (between 21 and 40 years). Association with autoimmune diseases was shown by 20.5% of cases while viral infection association was shown by few cases. Most cases showed remission (59%) and no deaths were reported upon follow-up. Histopathologically, the majority of cases have proliferative type followed by the necrotic type and few cases showed xanthomatous type. ConclusionsOur study has the largest number of KFD cases in this region. It is obvious that KFD has clinical, radiological, and pathological features that overlap with malignancy, especially lymphoma. Knowing this disease and careful diagnostic approach can help avoid misdiagnosis.

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Section: Discussionmentioning

confidence: 99%

Pathological Features and Clinical Characteristics of Kikuchi-Fujimoto Disease: A Tertiary Hospital Experience in Riyadh, Saudi Arabia

Alshieban

Masuadi

Alghamdi

et al. 2023

Cureus

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“…It is a rare self-limiting lymphadenopathy, more commonly described in females, those aged 20-40 years and are of Southeast Asia origin [2,3]. Although less common within the African population, a few cases of the disease have been reported from Gabon, Senegal, Morocco, and Tunisia [4][5][6]. e disease affects both adults and children.…”

Section: Discussionmentioning

confidence: 99%

Case Report of Kikuchi-Fujimoto Disease from Sub-Saharan Africa: An Important Mimic of Tuberculous Lymphadenitis

Sharma

Otieno

Shah

2020

Case Reports in Medicine

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Kikuchi-Fujimoto disease (KFD) is a rare form of painful lymphadenopathy, usually cervical, which is more common in Southeast Asia and rarely reported from Africa. Symptoms are usually nonspecific (fever, night sweats, etc.), and can mimic more common diseases such as tuberculosis (TB) in endemic areas. We report a case of a 29-year-old black African woman who was admitted with headache, neck pain, fever, and lymphadenopathy. She was found to have aseptic meningitis, eventually attributed to TB based on cervical node biopsy, although further histology suggested KFD. Blood tests for systemic lupus erythematosus (SLE) were negative; she had already been commenced on anti-TB treatment and had responded well and so was continued with this therapy. She was also later diagnosed with Hashimoto's thyroiditis 3 months after her diagnosis of KFD. Five months after stopping TB treatment, she was readmitted with the same symptoms and associated painless lymphadenopathy. Repeat biopsy was morphologically similar to that of 2017, and repeat evaluation confirmed SLE. She has since been managed by a rheumatologist and continues to do well.

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“…Despite the global distribution of the disease, it has a certain geographical distribution, with a higher incidence rate in Asia, including China, Japan, and some Southeast Asian countries [1,3–6] . Due to the non-specific clinical manifestation, HNL patients are easily misdiagnosed with malignant lymphoma or tuberculosis [7–9] . 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is an examination that integrates functional and anatomical images and has an important value in the diagnosis of tumors and inflammatory diseases [10] .…”

Section: Introductionmentioning

confidence: 99%

“…[1,[3][4][5][6] Due to the non-specific clinical manifestation, HNL patients are easily misdiagnosed with malignant lymphoma or tuberculosis. [7][8][9] 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is an examination that integrates functional and anatomical images and has an important value in the diagnosis of tumors and inflammatory diseases. [10] Previous studies on the 18F-FDG PET/ CT imaging characteristics of HNL mainly focused on case reports and small samples, which showed hypermetabolism in the lymph node lesions, but there is a lack of large sample studies to confirm that.…”

Section: Introductionmentioning

confidence: 99%

Analysis of the clinical manifestations and 18F-FDG PET-CT findings in 40 patients with histiocytic necrotizing lymphadenitis

Zhang

Liang

et al. 2021

Medicine

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Histiocytic necrotizing lymphadenitis (HNL) is a rare, benign, and self-limiting inflammatory disease that mainly involves the lymph nodes. There is a lack of large sample studies concerning the clinical manifestations and imaging features of 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) of HNL. The clinical symptoms, laboratory examination results, 18F-FDG PET/CT imaging features, and treatment outcome were investigated in this retrospective study. A total of 40 HNL patients were recruited. The onset age was between 14 and 65 years, with a median of 25 years. The white blood cell count was 3.9 (2.9, 7.1) × 10 9 /L, C-reactive protein level was 20.2 (6.6, 63.8) mg/L, erythrocyte sedimentation rate was 29.0 (18.0,45.0) mm/h, and ferritin was 616.5 (205.6, 2118.1) ng/mL. An abnormal liver function was observed in 23 patients. 18F-FDG PET-CT showed that an abnormal lymph node metabolism was observed in 38 patients, among which the highest 18F-FDG maximal standard uptake value (SUVmax) of the lymph nodes ranged between 3.4 and 41.9; the nodes were mainly distributed in the neck and axilla regions. Meanwhile, a total of 2502 lymph nodes (721 lymph nodes with a short axis greater than 10 mm) were found in the 38 patients, including 1837 lymph nodes with an 18F-FDG SUVmax ≥ 2.5. The 18F-FDG SUVmax of the spleen ranged from 2.5 to 9.2 in 20 patients, while that of central and peripheral bone marrow ranged from 2.7 to 36.0 in 30 patients. After follow-up for an average period of 1 month, the symptoms improved after prednisone treatment. HNL often occurs in adolescents. Scanning with 18F-FDG PET/CT showed that most patients had multiple involved lymph nodes that were hypermetabolic, and only few lymph nodes are enlarged. Besides, the spleen or central and peripheral bone marrow could sometimes be hypermetabolic. Glucocorticoid treatment for the HNL patients is effective.

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About a rare disease misdiagnosed as malignant lymphoma or tuberculosis: Kikuchi-Fujimoto’s disease

Cited by 7 publications

References 10 publications

Pathological Features and Clinical Characteristics of Kikuchi-Fujimoto Disease: A Tertiary Hospital Experience in Riyadh, Saudi Arabia

Pathological Features and Clinical Characteristics of Kikuchi-Fujimoto Disease: A Tertiary Hospital Experience in Riyadh, Saudi Arabia

Case Report of Kikuchi-Fujimoto Disease from Sub-Saharan Africa: An Important Mimic of Tuberculous Lymphadenitis

Analysis of the clinical manifestations and 18F-FDG PET-CT findings in 40 patients with histiocytic necrotizing lymphadenitis

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