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Kikuchi-Fujimoto Disease: A Differential for When It is Not Systemic Lupus Erythematosus. Case Rep Rheumatol 2022; 2022:7709246. [PMID: 35968155 PMCID: PMC9363934 DOI: 10.1155/2022/7709246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 06/30/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Abstract
Kikuchi-Fujimoto disease (KFD) is a rare and benign disease process that is characterized by fever and lymphadenopathy that was first described in young Japanese women in the early 1970s. Knowledge of KFD is important as it can often mimic other causes of lymphadenopathy including systemic lupus erythematosus (SLE) or malignancies, and this can lead to invasive diagnostic testing and even treatments that can be avoided. The etiology and exact mechanism by which KFD develops is not fully understood at this time, but is thought to be an immune response of T cells and histiocytes to viral or bacterial infections. We present a 35-year-old African-American woman who was referred to the rheumatology clinic by our colleagues in the breast clinic with new onset right axillary lymphadenopathy and abnormal serologic testing with the suspicion of SLE after a malignancy had been ruled out.
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Severe Fever with Thrombocytopenia Syndrome with Necrotizing Lymphadenitis in a Patient who Underwent 18F-FDG PET/CT: A Case Report. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph181910488. [PMID: 34639789 PMCID: PMC8508477 DOI: 10.3390/ijerph181910488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 09/30/2021] [Accepted: 10/02/2021] [Indexed: 11/17/2022]
Abstract
Severe fever with thrombocytopenia syndrome (SFTS), also known as fever, thrombocytopenia, and leukopenia syndrome, is an emerging tick-borne infectious disease in Asian countries. SFTS should be suspected in patients presenting with fever, thrombocytopenia, and leukopenia and have a history of tick exposure in an endemic area. Since SFTS can be accompanied by lymphadenopathy, particularly generalized lymphadenopathy, it can be confused with a primary malignancy, such as lymphoma. The study reports a case of SFTS accompanied by multiple lymphadenopathies, which mimicked malignant lymphoma on F-18 fluorodeoxyglucose positron emission tomography/computed tomography.
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Chen LC, Wang CJ, Chang YC, Shie SS, Lin TY, Hsieh YC, Arthur Huang KY, Kuo CY, Chiu CH, Huang YC, Chen CJ. Distribution of lymphadenopathy in patients with Kikuchi disease. JOURNAL OF MICROBIOLOGY, IMMUNOLOGY, AND INFECTION = WEI MIAN YU GAN RAN ZA ZHI 2019; 54:299-304. [PMID: 31615722 DOI: 10.1016/j.jmii.2019.08.016] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 07/17/2019] [Accepted: 08/13/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Cervical lymphadenopathy is among the cardinal manifestations of Kikuchi disease (KD). The incidences and locations of extra-cervical lymph nodes (LNs) involvement in KD have not been comprehensively reported. METHODS From 2003 to 2016, 60 patients with pathologically confirmed KD and with computed tomography and/or whole-body inflammation scans at diagnosis were retrospectively identified. The locations, sizes and characteristics of all affected LNs were analyzed by extensive review of the image studies. The clinical and laboratory parameters were abstracted from medical records and the associations with extra-cervical LNs involvement were identified. RESULTS Female accounted for 35 (58.3%) patients and the median age of all patients was 21.3 years (ranges, 3-64 years). Of 59 patients with evaluable neck images, 42 (71.2%) and 16 (27.1%) patients presented with unilateral and bilateral nodal involvement, respectively, with the most common locations at level II, III and IV by Som's classification. The largest LNs appeared most commonly in level II. The incidences of extra-cervical lymphadenopathy in abdomen, pelvis, inguina, axilla and mediastinum with available images were respectively 52.9% (9/17), 47.1% (8/17), 41.2% (7/17), 30.6% (11/36) and 14.3% (8/56). When compared to cases with solitary cervical lymphadenopathy, the cases with extra-cervical lymphadenopathy had significantly greater incidences of bilateral cervical lymphadenopathy (P = .0379) and leukopenia (P = .0173). CONCLUSION Unilateral cervical lymphadenopathy was the most frequent form of LNs involvement of KD. Extra-cervical lymphadenopathy was not uncommon and was associated with the appearance of bilateral distribution of cervical LNs and leukopenia.
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Affiliation(s)
- Lung-Chiung Chen
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, 333 Taoyuan, Taiwan; Department of Pediatrics, Taoyuan Armed Forces General Hospital, 325 Taoyuan, Taiwan
| | - Chao-Jan Wang
- Department of Radiology, Chang Gung Memorial Hospital, 333 Taoyuan, Taiwan
| | - Yu-Chuan Chang
- Department of Nuclear Medicine, Chang Gung Memorial Hospital, 333 Taoyuan, Taiwan; Department of Medical Imaging and Radiological Sciences, Chang Gung University, 333 Taoyuan, Taiwan
| | - Shian-Sen Shie
- Division of Infectious Diseases, Department of Internal Medicine, Chang Gung Memorial Hospital, 333 Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, 333 Taoyuan, Taiwan
| | - Tzou-Yien Lin
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, 333 Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, 333 Taoyuan, Taiwan
| | - Yu-Chia Hsieh
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, 333 Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, 333 Taoyuan, Taiwan
| | - Kuan-Ying Arthur Huang
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, 333 Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, 333 Taoyuan, Taiwan
| | - Chen-Yen Kuo
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, 333 Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, 333 Taoyuan, Taiwan
| | - Cheng-Hsun Chiu
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, 333 Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, 333 Taoyuan, Taiwan
| | - Yhu-Chering Huang
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, 333 Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, 333 Taoyuan, Taiwan
| | - Chih-Jung Chen
- Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, 333 Taoyuan, Taiwan; School of Medicine, College of Medicine, Chang Gung University, 333 Taoyuan, Taiwan.
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Kitchens WH, Jaye DL, Wedd JP, Magliocca JF. A Mimic of Posttransplant Lymphoproliferative Disease Following Liver Transplant. EXP CLIN TRANSPLANT 2017; 18:741-743. [PMID: 29108510 DOI: 10.6002/ect.2017.0063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Generalized lymphadenopathy after organ transplant is a concerning finding, often indicating the devel-opment of lymphoma. We describe a 52-year-old liver transplant recipient who had clinical symptoms and imaging concerning for posttransplant lymphoproliferative disease. However, histologic evaluation of a lymph node biopsy revealed that the patient actually had a much rarer but relatively benign condition, Kikuchi-Fujimoto disease (histiocytic necrotizing lymphadenitis). We discuss the epidemiology, clinical symptoms, diagnosis, histologic features, and treatment of this uncommon mimic of posttransplant lymphoproliferative disease.
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Affiliation(s)
- William H Kitchens
- From the Department of General, Transplant, and Liver Surgery, Medical University of Warsaw, Warsaw, Poland
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