Self-limiting COVID‐19-associated Kikuchi‐Fujimoto disease with heart involvement: case-based review

Background The association between COVID-19 infection and the development of autoimmune diseases is currently unknown, but there are already reports presenting induction of different autoantibodies by SARS-CoV-2 infection. Kikuchi-Fuimoto disease (KFD) as a form of histiocytic necrotizing lymphadenitis of unknown origin. Objective Here we present a rare case of KFD with heart involvement after COVID-19 infection. To our best knowledge only a few cases of COVID-19-associated KFD were published so far. Based on presented case, we summarize the clinical course of KFD and its association with autoimmune diseases, as well we discuss the potential causes of perimyocarditis in this case. Methods We reviewed the literature regarding cases of “Kikuchi-Fujimoto disease (KFD)” and “COVID-19” and then “KFD” and “heart” or “myocarditis” by searching medical journal databases written in English in PubMed and Google Scholar. Results Only two cases of KFD after COVID infection have been described so far. Conclusion SARS-CoV-2 infection can also be a new, potential causative agent of developing KFD.

Kikuchi disease: An unusual cause of cervical lymphadenopathy in a young female

Kikuchi-Fujimoto disease (KD), also known as histiocytic necrotizing lymphadenitis, is a rare cause of unilateral cervical lymphadenopathy usually described in adolescents and young adults with female preponderance. Clinically patients present with palpable lymphadenopathy, fever, and loss of weight. Hence, it should be differentiated from other causes of lymphadenopathy such as tuberculosis, lymphoma, or malignancy. Although the majority resolve spontaneously without treatment some may require non-steroidal anti-inflammatory drug or steroids. It may also be associated with systemic lupus erythematosus. Hence early detection, prompt diagnosis, and follow-up of the patient are essential in all cases of unilateral cervical lymphadenopathy in young adults. Here, we describe a 22-year old female who presented with unilateral neck swelling and was clinically diagnosed initially as a case of tuberculous lymphadenitis which on biopsy turned out to be KD.

Kikuchi Fujimoto Disease: A Case Report with Literature Review

Kikuchi-Fujimoto disease (KFD), also referred to as histiocytic necrotizing lymphadenitis, is an uncommon entity, usually benign, self-limiting disease characterised by fever and regional lymphadenopathy of unexplained aetiology. There is an increase in reported cases of KFD, particularly in Asia. It is important to recognize this condition because it may be confused for systemic lupus erythematosus (SLE), tuberculosis or lymphoma. The knowledge of this condition among clinicians and pathologists can help to avoid misdiagnosis and inappropriate treatment. It must be considered among the differential diagnoses of cervical lymphadenopathy. Here, we present a case of 20-year-old male who came to the hospital with complaints of mild fever, chills, fatigue and cervical lymphadenopathy. After radiological investigations an excisional biopsy of the cervical lymph node was done and the diagnosis of KFD was confirmed. Due to the paucity of cases in literature, reporting this case may help shed light on this rare disease.

Morphologic Spectrum of Lymphadenopathy in Drug Reaction With Eosinophilia and Systemic Symptoms Syndrome

Context.— Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DRESS) is a drug-induced, adverse T-cell–mediated hypersensitivity reaction that most often involves skin. The pathologic findings of DRESS-related lymphadenopathy have been described infrequently in the literature. Objective.— To present a case series of DRESS-related lymphadenopathy with an emphasis on the morphologic spectrum. Design.— We describe detailed clinical and pathologic findings along with the literature review. We focus on the differential diagnosis between DRESS lymphadenopathy and angioimmunoblastic T-cell lymphoma (AITL). Results.— There were 4 men and 1 woman with a mean age of 41 years (range, 23–59 years). One patient (20%) died. Three lymph node biopsy specimens showed a pattern reminiscent of AITL (AITL-like pattern) and 2 cases showed necrotizing lymphadenitis (Kikuchi-like pattern), associated with vasculitis in 1 case. The AITL-like morphology of DRESS-related lymphadenopathy may be difficult to distinguish from genuine AITL. The clinical information is important for differential diagnosis, including history of drug exposure, age, and the rarity or absence of AITL-associated manifestations such as hemolytic anemia and hypergammaglobulinemia. Molecular analysis of the T-cell receptor genes is helpful, typically revealing a polyclonal pattern in DRESS-related lymphadenopathy. Conclusions.— In the literature, 4 histologic patterns of DRESS lymphadenopathy have been described: reactive lymphoid hyperplasia, necrotizing lymphadenitis, Hodgkin lymphoma–like, and AITL-like. These patterns, particularly those that resemble lymphoma, highlight the importance of correct diagnosis to avoid unnecessary therapies.

Severe Fever with Thrombocytopenia Syndrome with Necrotizing Lymphadenitis in a Patient who Underwent 18F-FDG PET/CT: A Case Report

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.

Linfadenite granulomatosa necrotizante tuberculóide em paciente pediátrico: Relato de caso

A linfadenopatia cervical é um problema frequente nos pacientes pediátricos em muitos casos, representa reação transitória a processos infecto-inflamatórios locorregionais ou sistêmicos considerada a causa mais comum de linfadenopatia periférica em região cervical. A biópsia associada à análise histopatológica é considerada como padrão ouro para o diagnóstico de linfadenopatia cervical. A punção por agulha fina (PAAF) vem sendo utilizada como primeira linha de investigação no diagnóstico de edema em cabeça e pescoço, por ser simples, econômica e menos invasiva do que a biópsia incisional. Este estudo foi realizado por meio de uma busca de artigos científicos na base de dados eletrônicos, PubMed utilizando os descritores: Lymphadenitis; Tuberculosis, Lymph Node; Histiocytic Necrotizing Lymphadenitis, indexados que tratavam de relatos de casos clínicos e revisão da literatura. Além da revisão, foi apresentado um relato de caso de paciente pediátrico atendido no serviço de emergência pela equipe de Cirurgia e Traumatologia Buco-maxilo-facial, que após diagnóstico por exame histopatológico confirmou Linfadenite granulomatosa necrotizante tuberculóide, para discussão sobre as condutas de diagnóstico e tratamento.

Histiocytic Necrotizing Lymphadenitis Mimicking Acute Appendicitis in a Child: A Case Report

Background: Histiocytic necrotizing lymphadenitis, also known as Kikuchi-Fujimoto disease (KFD), is a self-limiting inflammatory disease with low incidence and high misdiagnosis rate in children. Furthermore, cases where the clinical presentation resembles acute appendicitis are very rare.Case Presentation: A 14-year-old boy was misdiagnosed as acute appendicitis and received operative treatment at his early visit. He suffered from abdominal pain, vomiting, diarrhea, fever, and lymphadenitis at the ileocecal junction, which were found by B-ultrasonography examination and surgery. Lymphadenectomy, as well as appendectomy, was performed, and KFD was identified by pathological examination. The patient was transferred to our hospital for further therapy because of recurrent fever and abdominal pain after the appendectomy. His temperature became normal after methylprednisolone was administered, and no recurrence was observed till now during follow-up.Conclusions: Necrotizing lymphadenitis involving mesenteric lymph nodes may cause acute-appendicitis-like symptom; KFD should be a diagnostic consideration for mesenteric lymphadenitis.

Kikuchi necrotizing lymphadenopathy: a tip of the iceberg disease?

Kikuchi-Fujimoto disease (KFD) is a rare benign condition also called histiocytic necrotizing lymphadenitis, which typically presented as fever with cervical lymphadenopathy in previously healthy individual. We presented a case of 11 year old boy with fever and cervical lymphadenopathy since 2 months. Lymph node biopsy was performed which suggested of KFD and was treated symptomatically. KFD incidence is rare but clinicians should be alert if young patient comes with fever and cervical lymphadenopathy to lower the chance of unwanted laboratory test and harmful treatment.