Hashimoto’s Thyroiditis and Kikuchi’s Disease: Presentation of a Case and Review of the Literature

We report the case of a 19-year-old woman with a history of Hashimoto’s thyroiditis who presented with tender right anterior cervical lymphadenopathy and fever. Workup for infectious, autoimmune, and malignant causes was unremarkable. Surgical removal of cervical lymph nodes after detailed magnetic resonance (MR) imaging disclosed necrotizing lymphadenitis, also known as Kikuchi’s disease (KD). The patient was treated with a short-term course of steroids, due to the onset of pancytopenia and borderline antiphospholipid antibodies combined with increased anti-thyroglobulin (anti-TG) titers. Despite being a diagnosis of exclusion, KD should be included in the differential of such patients, particularly in cases of previous or concurrent autoimmune diseases such as Hashimoto’s thyroiditis, which necessitate a long-term follow-up.

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Kikuchi’s disease associated with Hashimoto’s thyroiditis

Journal of Endocrinological Investigation ◽

10.1007/bf03349850 ◽

1996 ◽

Vol 19 (2) ◽

pp. 136-137 ◽

Cited By ~ 10

Author(s):

S. I. Rubio ◽

T. Sauer Plewinsky ◽

M. Sabatini ◽

Leonid Poretsky

Keyword(s):

Hashimoto’S Thyroiditis ◽

Hashimoto's Thyroiditis ◽

Kikuchi’S Disease ◽

Kikuchi's Disease

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Kikuchi-Fujimoto Disease: A Report of 3 Cases

Ear Nose & Throat Journal ◽

10.1177/014556130708600720 ◽

2007 ◽

Vol 86 (7) ◽

pp. 412-413 ◽

Cited By ~ 4

Author(s):

Eimear Phelan ◽

Emer Lang ◽

Peter Gormley ◽

John Lang

Keyword(s):

Weight Loss ◽

Cervical Lymphadenopathy ◽

Lymph Node Biopsy ◽

Accurate Diagnosis ◽

Histiocytic Necrotizing Lymphadenitis ◽

Kikuchi’S Disease ◽

Node Biopsy ◽

Night Sweats ◽

Necrotizing Lymphadenitis ◽

Kikuchi's Disease

Cervical lymphadenopathy has many underlying etiologies. One of its rare causes is Kikuchi-Fujimoto disease (Kikuchi's disease, histiocytic necrotizing lymphadenitis). We discovered such a cause in a 37-year-old woman who had presented with malaise, night sweats, and weight loss in addition to cervical lymphadenopathy. We based our diagnosis on excisional lymph node biopsy. We also review 2 other cases of Kikuchi's disease that were diagnosed by others at our institution. Clinically and histologically, Kikuchi's disease is very similar to lymphoma, and distinguishing the two is difficult. However, despite the fact that Kikuchi's disease is benign, an accurate diagnosis is important because misdiagnosis might lead to unnecessary surgery and/or chemotherapy.

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Histiocytic Necrotizing Lymphadenitis (Kikuchi’s Disease) of the Cervical Lymph Nodes

ORL ◽

10.1159/000276933 ◽

1997 ◽

Vol 59 (3) ◽

pp. 176-178 ◽

Cited By ~ 1

Author(s):

B.N. Kumar ◽

R.M. Walsh ◽

N.M. Walter ◽

J.T. Little

Keyword(s):

Lymph Nodes ◽

Histiocytic Necrotizing Lymphadenitis ◽

Cervical Lymph Nodes ◽

Kikuchi’S Disease ◽

Necrotizing Lymphadenitis ◽

Kikuchi's Disease

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Kikuchi's Disease: A Rare Cause of Fever and Lymphadenopathy

Clinical Medicine Insights Pathology ◽

10.4137/cpath.s8685 ◽

2012 ◽

Vol 5 ◽

pp. CPath.S8685 ◽

Cited By ~ 6

Author(s):

A Vivekanandarajah ◽

B Krishnarasa ◽

M Hurford ◽

S Gupta

Keyword(s):

Cervical Lymphadenopathy ◽

Lymph Node Biopsy ◽

Imaging Studies ◽

Benign Condition ◽

Kikuchi’S Disease ◽

Node Biopsy ◽

Cervical Lymph Node Biopsy ◽

Necrotizing Lymphadenitis ◽

Work Up ◽

Kikuchi's Disease

Kikuchi's disease is a benign condition that occurs in women. A young woman presented to the hospital with fevers and cervical lymphadenopathy. Infectious work-up was negative except for streptococcus pharyngitis. Imaging studies revealed the presence of diffuse cervical and axillary lymphadenopathy. The fevers persisted and she underwent excisional cervical lymph node biopsy that revealed histiocytic necrotizing lymphadenitis corresponding to a benign diagnosis of Kikuchi's disease. Three months later, the patient was afebrile and there was complete resolution of the cervical lymphadenopathy.

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Cervical lymphadenopathies: a diagnostic crisis

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20174310 ◽

2017 ◽

Vol 4 (5) ◽

pp. 1490

Author(s):

Priya Joy ◽

G. Gayathri ◽

V. Gangadharan

Keyword(s):

Lymph Nodes ◽

Elevated Serum ◽

Cervical Lymphadenopathy ◽

Kimura’S Disease ◽

Cervical Lymph Nodes ◽

Benign Condition ◽

Serum Ige ◽

Kikuchi’S Disease ◽

First Case ◽

Kikuchi's Disease

Cervical lymphadenopathy refers to lymphadenopathy of the cervical lymph nodes. The causes are varied, and may be inflammatory, degenerative, infective or neoplastic. The first case presented here is of a 29-year old male presented with h/o recurrent progressive right sided painless swelling in the infraparotid region with cervical lymphadenopathy for past one year. Swelling was 6×6cm, nontender, firm mass. Cervical lymph nodes were palpable. He had raised eosinophil counts and elevated serum IgE levels. Biopsy showed abundant eosinophilic infiltration with microabscess suggestive of Kimura’s disease. Second case reported here is of a 17-year old female patient presented with fever for 3 weeks with cervical lymphadenopathy. The lymph node was 3×2cm, tender and firm. Routine blood investigations showed anemia. Biopsy showed lymph nodes composed of sheets of macrophages with crescent shaped nuclei with areas of necrosis and karyhorrhexis suggestive of Kikuchi’s disease. Kimura’s disease is a relatively uncommon chronic inflammatory benign condition mostly affecting the lymph nodes, subcutaneous tissue and salivary glands of head and neck region. It is seen in males in their second decade of lives. Peripheral eosinophilia, regional lymphadenopathy and elevated serum IgE levels are characteristics of Kimura’s disease. Kikuchi-Fujimoto disease is a benign, idiopathic and self-limited disease. Affects young females between 20-35 years of age. Usually there will be localized painful lymphadenopathy, fever and leukopenia. Kikuchi disease runs a benign course and resolves in several weeks to months. The two cases are presented to make clinicians aware of Kimura’s disease and Kikuchi’s disease as a differential diagnosis of cervical lymphadenopathy and to avoid the diagnostic dilemma both clinically and histopathologically.

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

The Journal of Laryngology & Otology ◽

10.1017/s0022215100142021 ◽

1998 ◽

Vol 112 (9) ◽

pp. 898-900 ◽

Cited By ~ 15

Author(s):

N. A. Bhat ◽

Ye Lim Hock ◽

N. O. Turner ◽

A. R. Das Gupta

Keyword(s):

Lymph Nodes ◽

Unknown Origin ◽

Histiocytic Necrotizing Lymphadenitis ◽

Review Of The Literature ◽

Cervical Lymph Nodes ◽

Young Females ◽

Kikuchi’S Disease ◽

Necrotizing Lymphadenitis ◽

Kikuchi's Disease

AbstractHistocytic 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.

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Kikuchi's Disease: A Case Report

Faridpur Medical College Journal ◽

10.3329/fmcj.v8i2.20395 ◽

2014 ◽

Vol 8 (2) ◽

pp. 96-98

Author(s):

Md Shafiq-Ur Rahman ◽

Golam Muktadir ◽

SK Abdul Momen Ahmed

Keyword(s):

Early Recognition ◽

Cervical Lymphadenopathy ◽

Needle Aspiration ◽

Lymph Node Biopsy ◽

Unknown Etiology ◽

Histiocytic Necrotizing Lymphadenitis ◽

Cervical Lymphadenitis ◽

Kikuchi’S Disease ◽

Necrotizing Lymphadenitis ◽

Kikuchi's Disease

Kikuchi's disease is also known as histiocytic necrotizing lymphadenitis. Kikuchi-Fujimoto disease (KFD) or histiocytic necrotizing lymphadenitis, is a rare benign, self-limiting cervical lymphadenitis of unknown etiology. It predominantly affects young women and can closely mimic infective and immunological disorders. Recognition of this condition is crucial, specially because it can easily be mistaken for tuberculosis, lymphoma, or even adenocarcinoma. We report an 18 years old girl who presented with fever and cervical lymphadenopathy. She had multiple enlarged cervical lymphadenopathy. Examination of other systems was normal. Laboratory investigations were also normal. Fine needle aspiration cytology of the cervical node was not done. The patient took a course of oral antibiotics. Since the patient did not respond, lymph node biopsy was done and the histological features suggested the diagnosis of Kikuchi's disease. The Patient was treated symptomatically and complete remission occurred in few weeks. Although the incidence of Kikuchi-Fujimoto disease is rare, clinicians should be aware of this condition as early recognition of the disease will minimize potentially harmful and unnecessary evaluations and treatments. DOI: http://dx.doi.org/10.3329/fmcj.v8i2.20395 Faridpur Med. Coll. J. 2013;8(2): 96-98

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Kikuchi-Fujimoto Disease in a Filipino Boy: A Case Report

Philippine Journal of Otolaryngology Head and Neck Surgery ◽

10.32412/pjohns.v34i2.503 ◽

2019 ◽

Vol 34 (2) ◽

pp. 35-38

Author(s):

Jenina Rachel Escalderon ◽

Angelo Monroy

Keyword(s):

Case Report ◽

Private Hospital ◽

Cervical Lymphadenopathy ◽

Excision Biopsy ◽

Cervical Lymph Nodes ◽

History Of ◽

Necrotizing Lymphadenitis ◽

Supportive Management ◽

Multiple Diagnosis

Objective: To report a case of a 12-year-old boy with Necrotizing Lymphadenitis (Kikuchi-Fujimoto disease) presenting as lymphadenitis secondary to multiple diagnosis. Methods: Design : Case Report Setting: Tertiary Private Hospital Patient: One Results: A 12-year-old boy consulted for two-month history of cervical lymphadenopathy with the underlying cause remaining unclear despite multiple consults, diagnosis and medical treatment. Lymphoma was considered and excision biopsy with further investigations confirmed a diagnosis of Kikuchi-Fujimoto disease. Supportive management was given with no recurrence of symptoms noted on 18 months of follow up. Conclusion: Kikuchi-Fujimoto disease in this case was a diagnosis of exclusion. Even with a proper history and physical examination, experts in otolaryngology can be misled to manage this case as malignant. Awareness of the disease and appropriate examinations including immunohistochemistry are important for a timely diagnosis and proper intervention. Keywords: lympadenitis; Kikuchi-Fujimoto disease; lymphoma; cervical lymph nodes

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