scholarly journals Relapsing Kikuchi-Fujimoto Disease Requiring Prolonged Steroid Therapy

2019 ◽  
Vol 2019 ◽  
pp. 1-4
Author(s):  
Ulrich Gerwig ◽  
Rolf Guenter Weidmann ◽  
Gregor Lindner
Keyword(s):  
Lymph Nodes ◽  
Steroid Therapy ◽  
Lymph Node Biopsy ◽  
Therapeutic Trial ◽  
Cervical Lymph Nodes ◽  
Recurrent Headache ◽  
Node Biopsy ◽  
History Of ◽  
Necrotizing Lymphadenitis ◽  
Inflammatory Drugs

We report the case of a 26-year-old woman with an eight-week history of painfully enlarged cervical lymph nodes, recurrent headache, and malaise. Her medical history was unremarkable. The physical examination showed multiple enlarged cervical lymph nodes. Laboratory examination was unremarkable, and magnetic resonance tomographic imaging showed multiple enlarged cervical lymph nodes with aspect of a lymphoma. Lymph node biopsy revealed Kikuchi-Fujimoto disease, histologically characterized by histiocytic necrotizing lymphadenitis. A therapeutic trial with nonsteroidal anti-inflammatory drugs (NSAID) showed no effect, so steroid therapy was started. Due to relapse of symptoms after steroid withdrawal the tapering regimen was prolonged for a total of seven months.

scholarly journals Pediatric Cryptococcal Lymphadenitis in the Absence of AIDS: Case Report and Literature Review

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Fengchang Bao ◽  
Hongna Tan ◽  
Wei Liu ◽  
Yange Li ◽  
Huixia Li
Keyword(s):  
Lymph Nodes ◽  
Bone Marrow Aspiration ◽  
Excisional Biopsy ◽  
Lymph Node Biopsy ◽  
Cervical Lymph Nodes ◽  
Oral Fluconazole ◽  
Reactive Protein ◽  
History Of ◽  
Eosinophil Granulocytes ◽  
Intravenous Amphotericin

We present a rare case of cryptococcal lymphadenitis without immunocompromization in a two-and-a-half-year-old child. He was referred to our center with a fifteen-day history of continued fever. Ultrasound and computed tomography (CT) revealed the enlargement of multiple lymph nodes and lung reticulonodular shadows. Hematological, immunological, and microbiological tests for hepatitis, lymphoma, AIDS, and immunoglobulin deficiencies were negative. Laboratory tests demonstrated elevated erythrocyte sedimentation rate, elevated plasma and urinary ß2-microglobulin (ß2-MG) levels, and elevated C-reactive protein and fibrinogen. Both blood routine and bone marrow aspiration showed elevated eosinophil granulocytes. The diagnosis of cryptococcal lymphadenitis was obtained by excisional biopsy of the cervical lymph nodes. The patient was treated with intravenous amphotericin B and oral flucytosine for five weeks, then with subsequent oral fluconazole for three months. The patient is now doing well. Our case suggests that the diagnosis of cryptococcal lymphadenitis is very difficult without etiology and pathology, especially for a patient with a normal immune system; lymph node biopsy is necessary to diagnose it, and immediate antifungal treatment is necessary to treat it.

scholarly journals Misled by the Xpert-Kikuchi’s disease masquerading as tuberculosis

2020 ◽  
Vol 8 (1) ◽  
pp. 174
Author(s):  
Aparna Krishnakumar ◽  
Elayaraja Sivaprakasam ◽  
Latha Ravichandran ◽  
Umapathy Pasupathy ◽  
Sarala Premkumar ◽  
...  
Keyword(s):  
Past History ◽  
Previous Treatment ◽  
Lymph Node Biopsy ◽  
Tuberculous Lymphadenitis ◽  
Intact Cells ◽  
Node Biopsy ◽  
History Of ◽  
Necrotizing Lymphadenitis ◽  
Previously Treated ◽  
Tuberculosis Therapy

Kikuchi-Fujimoto disease (KFD), also called histiocytic-necrotizing lymphadenitis is a rare, idiopathic and self-limiting cause of lymphadenitis. Clinical presentation of KFD closely resembles nodal tuberculosis (TB). Here we present a case of an adolescent female whose diagnosis of KFD was made despite being misled in the course. A 15-year-old female, previously treated for tuberculous lymphadenitis was brought with complaints of fever for 1 month. Various possibilities considered were TB reactivation, autoimmune disorders, lymphoma. Lymph node biopsy for gene Xpert showed TB bacilli detected but low with no RIF resistance. Despite anti tuberculous treatment initiation, there was no improvement in the clinical condition. Histopathology of cervical node showed features of Kikuchi lymphadenitis. Literature search revealed that gene Xpert can detect the intact DNA of Mycobacterium tuberculosis even years after the previous treatment. On stopping anti tuberculosis therapy (ATT) and starting IV steroid, she started improving dramatically. KFD should always be kept as a differential diagnosis in any individual with fever and lymphadenopathy. Diagnosis can be misled in any patient based on gene Xpert reports alone which often turns out to be positive if there is past history of TB as gene Xpert detects DNA from non-intact cells suggesting that dead bacilli contribute to the false positivity.

scholarly journals Frequency of Infection in Cervical Lymph Node Biopsy Site using Chlorhexidine and Povidine Iodine

2018 ◽  
Vol 2 (1) ◽  
pp. 24-30
Author(s):  
Qudrat Ullah ◽  
Anam Parvaiz ◽  
Usman Ali Rehman ◽  
Asif Hanif ◽  
Sami Ullah Bhatti
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Cervical Lymph Node ◽  
Cervical Lymphadenopathy ◽  
Lymph Node Biopsy ◽  
Skin Preparation ◽  
Cervical Lymph Nodes ◽  
Node Biopsy ◽  
Cervical Lymph Node Biopsy ◽  
Povidine Iodine

Abstract:Background: Lymph node are located throughout the lymphatic system, they are concentrated in certain areas of the body including head and neck. Cervical lymph nodes are lymph nodes found in the neck. Of the 800 lymph nodes in the human body, 300 are in the neck. Cervical lymph nodes are subject to several different pathological conditions including tumours, infection and inflammation.Methodology: The Povidine-iodine and chlorhexidine for preoperative skin preparation in cervical lymph node biopsy procedure were used in this study and patients were asked for follow up after a week. On follow up day their wounds were checked, assessed and withdraw all stiches and complications were recorded accordingly and analysed them. It was discussed and showed that which one of Povidine-iodine and chlorhexidine is best to use for preoperative skin preparation in cervical lymph node biopsy procedures to reduce surgical site infection and economical one.Results: Out of 150 patients, 46% (69) were males and 54% (81) were females that had cervical lymphadenopathy after skin preparation by chlorhexidine antiseptic solution showed frequency of infection in total of 150 patients 16.67% (25) were infected while the other 83.33%(125) were not infected. Out of 150 patients who were underwent cervical lymphadenopathy after using povidine iodine skin preparatory antiseptic solution, 42% (63) were males and 58% (87) were females and among those frequency of infection showed 44.67% (67) were infected while the others 55.33% (83) were not.Conclusion: Preoperative scrubbing of the patient’s skin with chlorhexidine–alcohol is better than scrubbing with povidone–iodine for preventing surgical-site infection after cervical lymph node biopsy.

Cytologic Features of Lipogranulomatous Reaction in an Axillary Sentinel Lymph Node

2021 ◽  
pp. 1-4
Author(s):  
Jose Antonio Jimenez-Heffernan ◽  
Mariel Valdivia-Mazeyra ◽  
Patricia Muñoz-Hernández ◽  
Consuelo López-Elzaurdia
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Nodes ◽  
Breast Biopsy ◽  
Lymph Node Biopsy ◽  
Sentinel Lymph Nodes ◽  
Fat Necrosis ◽  
Histologic Analysis ◽  
Node Biopsy

Introduction: Multinucleated giant cells (MGC) are a rare finding when evaluating axillary sentinel lymph nodes. Some are described as foreign body-type MGC accompanied by foamy macrophages. They have been rarely reported in nodes from patients in which a previous breast biopsy was performed. The tissue damage induced by biopsy results in secondary changes including fat necrosis and hemorrhage that can migrate to axillary nodes. In this report, we illustrate a lipogranulomatous reaction in cytologic samples obtained during a sentinel lymph node examination of a woman previously biopsied because of breast carcinoma. We have found no previous cytologic descriptions and consider it an interesting finding that should be known to avoid diagnostic misinterpretations. Case: A 51-year-old woman underwent mastectomy of the right breast with a sentinel lymph node biopsy at our medical center. One month before, a control mammography revealed suspicious microcalcifications and a vacuum-assisted breast biopsy resulted in a diagnosis of high-grade intraductal carcinoma with comedonecrosis. Surgery with a sentinel lymph node biopsy was performed. The sentinel node was processed as an intraoperative consultation. Frozen sections and air-dried Diff-Quik stained samples were obtained. They showed abundant lymphocytes with MGC and tumoral cells. MGC showed ample cytoplasm with evident vacuoles of variable size. Occasional hemosiderin-laden macrophages were also present. The complete histologic analysis and immunohistochemical studies revealed no malignant cells. Histologic analysis showed, in subcapsular location, occasional MGC phagocyting lipid droplets. Hemosiderin-laden macrophages were a common finding. Conclusion: Lipogranulomas may appear at axillary sentinel lymph nodes because of fat necrosis induced by previous breast biopsy. The most important consideration is not confounding MGC with epithelial cell clusters. This can occur with not well-processed samples, especially if unmounted.

scholarly journals An AN OBSERVATIONAL STUDY OF SLN MAPPING IN PATIENTS OF LOCALLY ADVANCED BREAST CANCER FOLLOWING NCT

2020 ◽  
Vol 4 (2) ◽  
Author(s):  
Ankur Garg ◽  
Udbhav Kathpalia ◽  
Shweta Bansal ◽  
Manoj Andley ◽  
Sudipta Saha
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Adjuvant Chemotherapy ◽  
Lymph Nodes ◽  
Locally Advanced ◽  
Lymph Node Biopsy ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Node Biopsy ◽  
Neo Adjuvant Chemotherapy

Background : Locally advanced breast carcinoma (LABC) includes a wide range of clinical scenarios- advanced primary tumors (T4), advanced nodal disease and inflammatory carcinomas(1). Traditionally, treatment of LABC included a combination of Chemotherapy, Radiation and Surgery(2). However, there has been a shift to Neoadjuvant Chemotherapy in recent times.(3) Histological status and the number of axillary lymph nodes with metastasis is one of the most important prognostic factors and most powerful predictor of recurrence and survival in patients of breast carcinoma and remains so, even after neo-adjuvant chemotherapy. (3) Information derived from the sentinel lymph node is considered valuable, with less discomfort to the patient when compared with axillary dissection.(4) However, its role in detecting nodal metastasis after neo-adjuvant chemotherapy in LABC is still debatable and definitive studies to evaluate its role are still evolving. (5) Materials and Methods: Patients of LABC were evaluated using ultrasonography (USG) of axilla. Neo-adjuvant chemotherapy (NACT) was administered and patients were reassessed by USG of axilla. Thirty patients with node negative axillary status were subjected to Sentinel lymph node mapping using isosulfan blue followed by Modified Radical Mastectomy and Axillary Lymph Node Dissection. Histopathological evaluation of stained and unstained lymph nodes done and the data, thus obtained, was statistically analysed.   Results: Sentinel lymph node biopsy performed using Isosulfan Blue dye alone, after neo-adjuvant chemotherapy predicts the status of axillary lymph nodes with low accuracy.   Conclusions: Further studies would be required to establish the role of sentinel lymph node biopsy in patients with LABC after NACT.

scholarly journals Kikuchi necrotizing lymphadenopathy: a tip of the iceberg disease?

2021 ◽  
Vol 8 (9) ◽  
pp. 1602
Author(s):  
Sushil Singla ◽  
Mohitesh Kumar ◽  
Vinod Kumar Jat ◽  
Deepika Parwan
Keyword(s):  
Lymph Node ◽  
Laboratory Test ◽  
Young Patient ◽  
Healthy Individual ◽  
Cervical Lymphadenopathy ◽  
Lymph Node Biopsy ◽  
Histiocytic Necrotizing Lymphadenitis ◽  
Benign Condition ◽  
Node Biopsy ◽  
Necrotizing Lymphadenitis

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. 

Ocular non-teratoid medulloepithelioma with teratoid metastases in ipsilateral intraparotid lymph nodes

2019 ◽  
pp. 112067211987007
Author(s):  
Jayati Sarangi ◽  
Aanchal Kakkar ◽  
Diya Roy ◽  
Rishikesh Thakur ◽  
Chirom Amit Singh ◽  
...  
Keyword(s):  
Lymph Nodes ◽  
Histopathological Examination ◽  
Previous History ◽  
Rare Presentation ◽  
Cervical Lymph Nodes ◽  
Extranodal Extension ◽  
Positron Emission ◽  
Parotid Neoplasm ◽  
History Of ◽  
The Right

Purpose: To describe a rare presentation of a case of intraocular non-teratoid medulloepithelioma with teratoid metastases in ipsilateral intraparotid lymph nodes. Case description: A 9-year-old male child with previous history of ciliary body non-teratoid medulloepithelioma presented with a swelling in the right pre-auricular region for 1 month. Magnetic resonance imaging and positron emission tomography–computed tomography showed a right intraparotid mass with enlarged ipsilateral cervical lymph nodes. A core biopsy was taken from the lesion, which on microscopy showed a tumor composed of small round cells arranged in cords, tubules lined by multilayered cells, and in cribriform pattern. These cells were embedded in a hypocellular, loose myxoid matrix. Based on the histopathological characteristics and previous history, a diagnosis of medulloepithelioma metastastic to ipsilateral parotid gland was made. The patient underwent right total conservative parotidectomy and bilateral neck dissection. Histopathological examination revealed metastatic medulloepithelioma in five out of eight intraparotid lymph nodes, with extranodal extension into the adjacent parotid parenchyma. Foci of hyaline cartilage were identified within the tumor, leading to a diagnosis of metastatic teratoid medulloepithelioma. Conclusion: Intraparotid lymph node metastases from intraocular medulloepithelioma is a rare possibility and we recommend that the parotid should be evaluated in cases of intraocular medulloepithelioma at initial presentation as well as during the follow-up period. Also, metastasis should be considered in all pediatric patients with solitary mass lesions showing unconventional histology for a primary parotid neoplasm.

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