scholarly journals Rare Presentation of Self-Limiting Kikuchi–Fujimoto Disease in Relapsing Nature

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Karo Servatyari ◽  
Hero Yazdanpanah ◽  
Chamara Dalugama
Keyword(s):  
Lymph Nodes ◽  
Wide Spectrum ◽  
Clinical Manifestations ◽  
Cervical Lymphadenopathy ◽  
Excision Biopsy ◽  
Presentation Of Self ◽  
Rare Presentation ◽  
Cervical Lymph Nodes ◽  
One Year ◽  
Loss Of Appetite

Background. Kikuchi–Fujimoto disease (KFD) is a rare, benign, and self-limiting disease that is commonly associated with cervical lymphadenopathy and fever. The disease has a wide spectrum of clinical manifestations, and definitive diagnosis is based on the histological appearance in the excision biopsy of the lymph nodes. Recurrence of KFD is reported rarely. Case Presentation. A 56-year-old Iranian woman with a background history of thrombocytopenia presented with fever, malaise, loss of appetite, and weight loss with cervical lymphadenopathy. The excision biopsy of the cervical lymph nodes confirmed the diagnosis of KFD, and she made a full recovery with improvement of symptoms, regression of cervical lymph nodes, and normalization inflammatory markers. One year after remission, she presented with similar clinico-biochemical profile, and repeat biopsy confirmed KFD. Conclusion. Although the rate of recurrence of the disease is very low, the treating physician should consider the possibility and confirm it histologically.

scholarly journals UTILITY OF ULTRASONOGRAPHY DIAGNOSIS FOR CERVICAL LYMPHADENOPATHY IN CENTRAL INDIAN POPULATION- A HOSPITAL BASED OBSERVATIONAL STUDY

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Neerja Jain Sudhakar ◽  
Dr. C. Sudhakar ◽  
Dr. Priyadershini Rangari
Keyword(s):  
Lymph Nodes ◽  
Indian Population ◽  
Cervical Lymphadenopathy ◽  
Excision Biopsy ◽  
Tuberculous Lymphadenitis ◽  
Metastatic Node ◽  
Cervical Lymph Nodes ◽  
Round Shape ◽  
Time Linear ◽  
Keywords Ultrasonography

Background: Cervical lymph nodes are frequently involved in a number of disease conditions. The most commonly seen causes of cervical lymphadenopathy are tuberculosis, distant metastasis and lymphoma. Objective: To assess the usefulness of ultrasonography in the differential diagnosis of cervical lymphadenopathy. Methods: ultrasonography of cervical lymph nodes was performed with a real-time linear scanner using a 7.5- or 11-MHz probe. Ultrasonography findings were retrospectively reviewed in 432 lymphnodes of 120 patients. USG findings were reevaluated by FNAC, CECT neck, MRI and core needle biopsy wherever required. Results: out of 432 lymphnodes; 108 tuberculous lymphadenitis, 46 metastatic, 59 lymphoma, 114 inflammatory and 105 normal lymph nodes were observed. Ultrasonography features were found to be stronger in tubercular, metastatic and lymphomatous lymphnodes. Hypoechoic center was prominently observed in tubercular and metastatic form. In most of the patients, FNAC result was equivocal and a subsequent excision biopsy of the lymph node was carried out to confirm the diagnosis. Lymphadenitis was diagnosed with a sensitivity of 100% and a specificity of 100%. Conclusion: This study concluded that cervical group of lymph nodes with ultrasonography features such as round shape, absence of hilar echo, sharp nodal borders, Hypoechoic internal echogenicity and presence of intranodal necrosis were highly suggestive of metastatic cervical lymph nodes. Ultrasonography along with other radiological and histopathological parameters can be very effective in early diagnosis of high risk diseases. Keywords: Ultrasonography; Tuberculous Lymphadenitis; Malignant Lymphoma; Metastatic Node

scholarly journals Exclusive abdominal lymphadenopathy as a rare presentation of sarcoidosis

2018 ◽  
Vol 97 (6) ◽  
pp. 585-588
Author(s):  
Matheus De Carvalho Santos ◽  
Ana Júlia Araujo de Carvalho ◽  
Helena Telles Furtado dos Santos ◽  
Matheus Heringer Gomes ◽  
Thiago Arruda Rezende
Keyword(s):  
Lymph Nodes ◽  
Clinical Manifestations ◽  
Immunohistochemical Analysis ◽  
Mesenteric Lymph Nodes ◽  
Rare Presentation ◽  
Symptomatic Disease ◽  
First Line Therapy ◽  
Cell Mediated Immune Response ◽  
One Year ◽  
Upper Abdomen

Sarcoidosis is a systemic granulomatous disease. The disease’s immunopathogenic mechanism is the activation of a cell mediated immune response. Lung is the most affected organ, but up to 30% of patients can have extrapulmonary manifestations. Case report: A 21-year-old male presented with a history of nausea, vomiting after meals, epigastric and periumbilical pain for approximately 6 months. Hyporexia and loss of 35 kilograms in 7 months were present, in addition to intermittent low nocturnal fever. His computed tomography (CT) scan (Figure 1) of the abdomen showed the presence of multiple, enlarged mesenteric lymph nodes with homogenous shape, measuring up to 2.0 cm in diameter, extending from the upper abdomen to the pelvis. Histopathologic findings of this lymph nodes showed a sarcoid appearance (Figure 2). Lymphoma, tuberculosis and other infections were excluded through immunohistochemical analysis. Treatment with prednisone was started initially at a dose of 40mg and after 5 weeks the patient were asymptomatic. One year and three months after the onset of treatment, corticosteroid dose reduction was attempted 3 times, with all of them leading to disease relapses. Treatment was optimized with 60mg of prednisone (for 2 weeks) plus 100mg of azathioprine daily. Discussion: The prevalence of gastrointestinal system involvement with clinical manifestations is 0,1 to 0,9%. However, the incidence of subclinical involvement can be higher. Enlarged lymph nodes is present in approximately 30% of cases. Treatment is indicated in sarcoidosis for patients with damage organ function or symptomatic disease and the first-line therapy is corticosteroid.

scholarly journals Cervical lymph node enlargement as the initial manifestation of rectal cancer

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Tong-Hui Xie ◽  
Peng Su ◽  
Jian-Guo Hong ◽  
Hui Zhang
Keyword(s):  
Colorectal Cancer ◽  
Rectal Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Cervical Lymph Node ◽  
Clinical Manifestations ◽  
Initial Symptom ◽  
Cervical Lymph Nodes ◽  
Supraclavicular Lymph Nodes ◽  
Lymph Node Enlargement

Abstract Background Colorectal cancer is a very common malignant tumor worldwide. The clinical manifestations of advanced colorectal cancer include the changes in bowel habits, hematochezia, diarrhea, local abdominal pain and other symptoms. However, the colorectal cancer with an initial symptom of cervical lymph node enlargement is extremely rare. In this article, we report a case of rectal cancer presenting with cervical lymph nodes enlargement as the initial symptom. Case presentation A 57-year-old woman was admitted to our hospital for cervical lymph node enlargement which was accidentally detected during physical examination. Computed tomography scan revealed multiple enlarged lymph nodes in the neck. Cervical ultrasound showed normal thyroid gland and multiple left supraclavicular lymph nodes enlargement. The patient underwent lymph nodes biopsy and pathologic results showed metastatic adenocarcinoma. The subsequent lower gastrointestinal endoscopy revealed a mucosal bulge lesion located at rectus and biopsy revealed adenocarcinoma. The patient underwent rectal cancer resection. She is alive with no evidence of recurrence or new tumors 2 years after surgery. Conclusions Cervical lymph node metastasis is a rare metastatic way in colorectal cancer. This is the first case of rectal cancer presenting with cervical lymph nodes metastases as the initial symptom. Surgical resection combined with postoperative chemotherapy improved long-term prognosis of the patient. This rare metastatic way of rectal cancer should be paid attention for clinicians.

scholarly journals Histomorphological Pattern of Cervical Lymphadenopathy

2013 ◽  
Vol 3 (1) ◽  
pp. 13-17 ◽  
Author(s):  
Md Atiqur Rahman ◽  
Md Mamun Ali Biswas ◽  
Syeda Tasfia Siddika ◽  
Abdul Mannan Sikder
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Hodgkin Lymphoma ◽  
Cervical Lymphadenopathy ◽  
Histological Evaluation ◽  
Cervical Lymph Nodes ◽  
Female Ratio ◽  
Study Results ◽  
Metastatic Neoplasm ◽  
Age And Sex

Background: Enlarged palpable cervical lymph nodes as a primary presenting sign are very common and may be due to inflammatory lesions and tumors. Correlation between clinical findings and laboratory data is essential in arriving at a diagnosis. In patients presenting with cervical lymphadenopathy, excision biopsy provides material to establish an early diagnosis. We designed this study in our population for histological evaluation of cervical lymph node biopsies that might be important in the management of these patients. Objective: Histopathological evaluation of different diseases involving the cervical lymph nodes in relation to age and sex of the study population. Materials and Methods: It was a cross sectional study conducted in the department of Pathology, Enam Medical College & Hospital, Savar, Dhaka during the period from January 2006 to December 2010. A total of 107 patients were evaluated for specific cause of cervical lymphadenopathy in relation to age and sex. Lymph node biopsies of all patients of both sexes and all age groups were included in the study. Results: Among the 107 subjects 58 (54.2%) were males and 49 (45.8%) were females with a male to female ratio of 1.2:1. The age of the patients ranged from 2 to 85 years with a mean age of 32.68 ± 18.01 years. Of the 107 lymph node biopsies, 34 cases (31.8%) were reactive lymphadenitis, 41 cases (38.3%) were tuberculosis, 2 cases (1.9%) were non-caseous granuloma, 6 cases (5.6%) were Hodgkin lymphoma, 8 cases (7.5%) were non-Hodgkin lymphoma, 12 cases (11.2%) were metastatic neoplasm and 4 cases (3.7%) were other specific lesions. Conclusion: The commonest cause of cervical lymphadenopathy was tuberculosis, followed by reactive lymphadenitis, lymphoma and metastatic neoplasm. DOI: http://dx.doi.org/10.3329/jemc.v3i1.13837 J Enam Med Col 2013; 3(1): 13-17

scholarly journals A prospective clinico-pathological study of cervical lymphadenopathy

2017 ◽  
Vol 4 (12) ◽  
pp. 3967
Author(s):  
Narender N. R. ◽  
Yadagiri Rao J.
Keyword(s):  
Lymph Nodes ◽  
Prospective Observational Study ◽  
Primary Tumour ◽  
Cervical Lymphadenopathy ◽  
Needle Aspiration ◽  
Excision Biopsy ◽  
Medical Sciences ◽  
Aspiration Cytology ◽  
Needle Aspiration Cytology ◽  
Carcinoma Tongue

Background: Lymphadenopathy refers to one or more lymph nodes that are abnormal in size, consistency or number. There are various causes for lymphadenopathy which range from benign conditions to malignant either primary or secondary from draining primary tumour. Lymphadenopathy can be localised to a single group or generalised.Methods: Prospective observational study was performed for the patients attending outpatient department of general surgery at Kamineni academy of medical sciences, LB nagar Hyderabad, Telangana with complaints of enlarged or swollen lymph nodes in the neck. This study included 46 cases. In cases where fine needle aspiration cytology was inconclusive and there was need for excision biopsy, only these cases were included in the study. After biopsy lymph node was sent for gross and microscopic examination for expert opinion from department of pathology.Results: The present study includes 46 patients in a period of two years from 01-8-2015 to 31-7-2017. Of these case tuberculosis lymphadenopathy (n=25,54.3%) was the most common aetiology followed by nonspecific chronic lymphadenopathy (n=16,34.7%) followed by some relatively rare cases and unusual presentation Schwannoma, pleomorphic adenoma, Kikuchi disease, non-Hodgkin’s lymphoma and secondaries from carcinoma tongue (n=1,2.1%).Conclusions: In the present prospective study tubercular lymphadenopathy was the most common cause for cervical lymphadenopathy followed by chronic nonspecific lymphadenopathy. 

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.

scholarly journals SAT-LB63 A Case of PTHrP-Negative Hypercalcemia of Malignancy

2020 ◽  
Vol 4 (Supplement_1) ◽  
Author(s):  
Jonila Murati ◽  
Ariana Cannavo ◽  
Sun Lee ◽  
Elizabeth N Pearce
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Elevated Serum ◽  
Cervical Lymphadenopathy ◽  
Neck Mass ◽  
Common Finding ◽  
Cervical Lymph Nodes ◽  
Hypercalcemia Of Malignancy

Abstract Case Presentation: A 55-year-old male who had recently arrived from Haiti presented to the Emergency Department with chief complaint of a progressively enlarging neck mass. He first noticed the mass in 2000. From 2000-2017, he underwent resection of the mass three times in Haiti, with recurrence after each surgery. On presentation, he reported unintentional 10 kg weight loss over several months and night sweats. Endocrine was consulted for evaluation of hypercalcemia. On examination and imaging, 8.7 x 14.0 x 14.0 cm fungating tumor on the nape of his neck extending to the occipital area and cervical lymphadenopathy were noted. Labs were notable for WBC of 21.7 K/uL, hemoglobin of 6.0 g/dL, calcium of 12.0 mg/dL, albumin of 3.1 g/dL, free calcium of 6.4 mg/dL, corrected calcium of 12.6 mg/dL, phosphorus of 2.6 mg/dL, and intact PTH of < 4 pg/mL. The PTH-related peptide (PTHrP) level was found to be normal at 19 pg/mL (reference range 14–27 pg/mL). SPEP was normal. Neck mass and cervical lymph nodes were biopsied. Histopathological examination of neck mass showed an ulcerated, moderately-differentiated squamous cell carcinoma with multifocal areas of necrosis. There was no evidence of malignancy in the cervical lymph nodes. CT scan showed 3 mm lung nodules, thought to be granulomas, and no clear evidence of metastatic disease. Hypercalcemia was treated with IV hydration and one dose of bisphosphonate and patient underwent resection of neck mass. Immediately after surgery, his calcium level precipitously decreased and has remained normal in the months since surgery. Discussion: Hypercalcemia of malignancy is a common finding affecting up to 44.1% of patients with malignancy (1,2). The major mechanism, accounting for approximately 80% of malignancy-related hypercalcemia, is mediated via PTHrP, which can cause hypercalcemia by increasing bone resorption and renal tubule calcium reabsorption (2). Squamous cell carcinoma (SCC), especially of the lungs, breast, or GI tract, is more frequently associated with hypercalcemia. There are also several case reports of primary cutaneous SCC associated with hypercalcemia. In these cases, tumors were large and hypercalcemia was thought to be due to elevated PTHrP (3,4,5). The skin has been shown to express PTHrP and PTHrP receptors (10). PTHrP has also been detected in 100% of cutaneous SCCs even in the absence of hypercalcemia. (6,7). Furthermore, PTHrP mRNA has been localized in 100% of squamous tumors with hypercalcemia and PTHrP peptide were detected in 91% of cases in a study of 11 patients (9). The patient presented in this case did not have an elevated level of PTHrP. However, resolution of hypercalcemia with resection of the mass supports a diagnosis of hypercalcemia of malignancy. This case illustrates that hypercalcemia due to primary cutaneous SCC typically, but not always, results in an elevated serum PTHrP level.

scholarly journals Extranodal (cutaneous) Rosai Dorfman: a rare presentation

2017 ◽  
Vol 6 (1) ◽  
pp. 370
Author(s):  
Ashwini Khadatkar ◽  
Nishant Ghodake
Keyword(s):  
Lymph Nodes ◽  
Clinical Course ◽  
Unknown Etiology ◽  
Extranodal Involvement ◽  
Rare Presentation ◽  
Cervical Lymph Nodes ◽  
Rosai Dorfman Disease

Rosai Dorfman disease is a rare histiocytic disorder of unknown etiology commonly involving the cervical lymph nodes first described in 1969, Extranodal involvement is very rare. Clinical course is variable.

scholarly journals Causes and Presentation Of Cervical Lymphadenopathy

2018 ◽  
Vol 4 (2) ◽  
pp. 31-35
Author(s):  
Arifullah Bangash ◽  
Syed Zafar Hassan ◽  
Ghulam Muhammad
Keyword(s):  
Lymph Nodes ◽  
Teaching Hospital ◽  
Acute Inflammation ◽  
Cervical Lymphadenopathy ◽  
Excisional Biopsy ◽  
Descriptive Study ◽  
Lymph Node Involvement ◽  
Cervical Lymph Nodes ◽  
Node Involvement ◽  
Reactive Hyperplasia

OBJECTIVETo determine the proportion of cervical lymphadenopathy in systemic diseases, their presentation and investigative tools.METHODOLOGYThis descriptive study was carried out from 1st July 2014 to 30 June 2017 in ENT and head and neck department Naseer Teaching Hospital and Town Teaching Hospital, Peshawar. Total of 270 patients with enlarged cervical lymph nodes, of either sex and of any age were approached for inclusion into the study. Patients with suspected acute inflammation were given a trial of antibiotic and followed for two weeks were excluded from the study. Excisional biopsy of the lymph nodes was performed in all these patients with six weeks or more duration.RESULTSIn our study out of 270 patients, 158 (58.5%) were males and the majority of patients (63.3%) had ages from 11-40 years. Tuberculous cervical lymphadenopathy was diagnosed in 145 (53.7%) patients, reactive hyperplasia in 53 (19.6%), lymphoma in 32 (11.8 %,) metastasis to cervical lymph nodes in 30 (11.1%), sarcoidosis in 7 (2.6%) and other very rare conditions as Kawasaki, Kikuchie and Rosi Dorfman were found in only one of each (0.4%). About 136 (50.4%) of the patients had involvement of multiple lymph nodes while 134 (49.6%) had single swelling. The matted lymph nodes were found in 162 (60%) whereas discrete lymph nodes were found in only 108 (40%) cases. Cold abscess was found in 19 (7%) of patients.CONCLUSIONTuberculosis is the commonest cause of cervical lymphadenopathy, with the majority of these patients having multiple lymph node involvement. In children, usually cervical lymphadenopathy is reactive or infective while in older age mostly metastatic.

Kikuchi Disease in Korean Children: Clinical Features and Disease Courses.

Blood ◽  
2007 ◽  
Vol 110 (11) ◽  
pp. 2285-2285 ◽  
Author(s):  
Jun Eun Park ◽  
Hyun Joo Jung ◽  
Chul-Ho Kim ◽  
Jeong Hong ◽  
Jae Ho Han
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Medical Center ◽  
University Hospital ◽  
First Episode ◽  
Excision Biopsy ◽  
Cervical Lymph Nodes ◽  
Korean Children ◽  
Presenting Symptoms

Abstract OBJECTIVES: Kikuchi’s disease (KD) is a benign, self-limiting disorder of unknown origin with lymphadenopathy and fever, and prevalent in young Asian women. The initial presentations mimic malignancies or other serious infections, and the biopsy of lymph nodes affected is the only definite diagnostic tool of KD. We analyzed data from a series of pediatric cases collected at a single medical center and suggest proper guideline of management for patients with KD. METHODS: The medical records of children under 16 years of age, who underwent lymph node biopsies and received histiopathologic diagnosis of KD at Ajou University Hospital, South Korea from January 2000 to June 2007, were retrospectively reviewed. RESULTS: Twenty six pediatric patients with KD included 10 boys and 16 girls. In all cases except two, the cervical lymph nodes were involved. Twenty (76.9%) patients had fever as a presenting symptom, and 5 patients (19.2%) had various skin rash. Leukopenia was noted in 8 cases (30.8%), but there was no case of leukocytosis. The levels of ESR and LDH were slightly elevated, but CRP and liver enzymes were within normal range. No KD patients in this study developed any other autoimmune disorders during follow-up period. Eleven (55%) cases with fever improved immediately after excision biopsy of affected lymph nodes. Eight (30.8%) cases treated with steroid showed dramatic responses. Six patients (23.1%) had resolutions of symptoms simply with symptomatic treatments. The recurrence happened in 6 (23.1%) children within a few weeks from the first episode. CONCLUSIONS: Contrary to previous reports on Asian cases, KD in Korean children is not rare in young boys, and fever is more common presenting symptoms. It’s relationship with autoimmune diseases or infection of EBV is not clear. Symptoms such as fever improved in some cases only by the removal of affected lymph node for excision biopsy. In agreement with previous reports, patients treated with steroid recovered dramatically. Therefore, we suggest an earlier excision biopsy for patients suspicious with KD and an immediate treatment of cases with severe symptoms with steroid. The recurrence rate in this study was higher than that in previous studies, therefore, a spell of follow-up period after disappearance of symptoms is advisable for patients with original diagnosis of KD.

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