Kikuchi's disease of the neck (histiocytic necrotizing lymphadenitis)

Abstract

Histocytic necrotizing lymphadenitis (HNL), also known as Kikuchi's disease is a benign self limiting disease of unknown origin. It effects cervical lymph nodes, predominantly in young females. It is well described in the pathology literature, but little is written about this in the ENT literature, as few clinicians are probably aware of this condition. Five cases of cervical Kikuchi's disease are presented with a brief review of the literature.

Necrotizing Cervical Lymphadenitis Caused by Mycobacterium simiae in an HIV-Positive Patient: Imaging with 18F-FDG PET/CT

“…To our knowledge, this is the first report of 18 F-FDG PET/ CT imaging of an infection caused by M. simiae in a human patient. 18 F-FDG PET/CT cannot differentiate among the different causes of necrotizing cervical lymphadenitis, which can be caused by different bacteria, including Mycobacterium tuberculosis, Mycobacterium avium intracellulare, Histoplasma capsulatum, Coccidioides immitis, Bartonella henselae, Francisella tularensis, Chlamydia trachomatis L2, Yersinia pseudotuberculosis and Yersinia enterocolitica; and nonbacterial causes such as viral pathogens (e.g., Herpes simplex, Parvovirus B19) [13][14][15], lymphoma, metastatic carcinoma [15] and Kikuchi disease [16][17][18]. However, in this case, the PET/CT whole-body scan was very helpful in identifying multiple sites of infection within the neck, in ruling out disseminated infection or infectious foci outside the neck, and in guiding biopsy and subsequent therapy.…”

Histiocytic Necrotizing Lymphadenitis (Kikuchi-Fujimoto Disease) Diagnosed by Fine Needle Aspiration Biopsy

“…Atypical lymphocytes may also be detected in the Mannarà/Boccato/Rinaldo/La Rosa/Ferlito peripheral blood [1]. There are no laboratory tests available to confirm the diagnosis of HNL [20]. Histologically, HNL is characterized by foci of necrosis in the lymph node cortex and paracortex, associated with a cellular infiltrate composed of histiocytes, plasmacytoid monocytes, macrophages and transformed lymphoid cells (immunoblasts).…”

“…FNAB has often been considered inconclusive [20,23] and García et al [15] believed that this disease cannot be diagnosed on FNAB. In our patient, however, the diagnosis of HNL was posed by FNAB on initial assessment.…”

Kikuchis Disease

“…It is a benign self limiting condition of unknown origin [1,2]. The disease usually presents in young women with cervical lymphadenopathy.…”