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 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 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. 

scholarly journals Kikuchi-Fujimoto Disease: A Report of 3 Cases

2007 ◽  
Vol 86 (7) ◽  
pp. 412-413 ◽  
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.

scholarly journals Take a second look: it's Kikuchi’s disease! A case report and review of literature

2018 ◽  
Vol 8 (4) ◽  
Author(s):  
Oana Joean ◽  
Thea Thiele ◽  
Mieke Raap ◽  
Reinhold E. Schmidt ◽  
Matthias Stoll
Keyword(s):  
Differential Diagnosis ◽  
Lymph Node Biopsy ◽  
Review Of Literature ◽  
Common Cause ◽  
Systemic Involvement ◽  
Kikuchi’S Disease ◽  
Node Biopsy ◽  
Necrotizing Lymphadenitis ◽  
Generalized Lymphadenopathy ◽  
Kikuchi's Disease

Generalized lymphadenopathy is a common cause of concern for both patients and clinicians. Possible etiologies include infections, malignancies and autoimmune diseases. Kikuchi Fujimoto disease (KFD) is a hyperergic condition that presents with fever, lymphadenopathy and can include systemic involvement, thus being easily mistaken for the above-mentioned entities. We report the case of a previously healthy 18-year-old male who presented with a selflimiting generalized lymphadenopathy, high fevers, skin vasculitis and polyserositis. The lymph-node biopsy revealed a histiocytotic necrotizing lymphadenitis, suggestive of Kikuchi’s disease. This case emphasizes the importance of KFD in the differential diagnosis of lymphadenopathy, especially in young adults.

scholarly journals Liver hilar tuberculous lymphadenitis successfully diagnosed by laparoscopic lymph node biopsy

2015 ◽  
Vol 10 ◽  
pp. 191-194 ◽  
Author(s):  
Masaki Wakasugi ◽  
Masahiro Tanemura ◽  
Tsubasa Mikami ◽  
Kenta Furukawa ◽  
Masahiko Tsujimoto ◽  
...  
Keyword(s):  
Lymph Node ◽  
Lymph Node Biopsy ◽  
Tuberculous Lymphadenitis ◽  
Node Biopsy

The History of Sentinel Lymph Node Biopsy

2015 ◽  
Vol 21 (1) ◽  
pp. 3-6 ◽  
Author(s):  
Omgo E. Nieweg ◽  
Roger F. Uren ◽  
John F. Thompson
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Sentinel Lymph Node Biopsy ◽  
Lymph Node Biopsy ◽  
Node Biopsy ◽  
History Of

scholarly journals Hepatocellular Carcinoma Metastasis to the Orbit in a Coinfected HIV+ HBV+ Patient Previously Treated with Orthotopic Liver Transplantation: A Case Report

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
S. Guerriero ◽  
G. Infante ◽  
E. Giancipoli ◽  
S. Cocchi ◽  
M. G. Fiore ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Past History ◽  
Bone Biopsy ◽  
Biopsy Specimens ◽  
First Case ◽  
History Of ◽  
Previously Treated ◽  
Carcinoma Metastasis ◽  
End Stage ◽  
Irregular Mass

Hepatocellular carcinoma rarely metastasizes to the orbit. We report a 45-year-old male, HBV+, HIV+, with a past history of a liver transplant for ELSD (end-stage liver disease) with hepatocellular carcinoma and recurrent HCC, who presented with proptosis and diplopia of the left eye. CT scans of the head revealed a large, irregular mass in the left orbit causing superior and lateral destruction of the orbital bone. Biopsy specimens of the orbital tumor showed features of metastatic foci of hepatocellular carcinoma. Only 16 other cases of HCC metastasis to the orbit have been described in literature, and this is the first case in a previously transplanted HIV+, HBV+ patient.

scholarly journals The Dangers of Immediately Performing a Sensitive and Specific Investigation versus the Dangers of Delaying It: A Cautionary Case of Hodgkin’s Lymphoma

2020 ◽  
Author(s):  
Takahiro Ito ◽  
Hiroshi Sawachika ◽  
Yukinori Harada ◽  
Taro Shimizu
Keyword(s):  
Lymph Node ◽  
Hodgkin’S Lymphoma ◽  
Gastrointestinal Endoscopy ◽  
Lymph Node Biopsy ◽  
Hodgkin's Lymphoma ◽  
Haemophagocytic Lymphohistiocytosis ◽  
Gastrointestinal Malignancies ◽  
Node Biopsy ◽  
History Of ◽  
Diagnostic Outcome

A 60-year-old man was admitted with a 1-month history of fever and weight loss. Multiple lymphadenopathies and haemophagocytic lymphohistiocytosis were noted from the beginning, suggesting lymphoma. However, lymph node biopsy was deferred because lymph node biopsy was regarded as being invasive and requires general anaesthesia, and because other possible differential diagnoses including gastrointestinal malignancies and TAFRO syndrome were being considered. Instead, investigations including gastrointestinal endoscopy and bone marrow biopsy were prioritized. The patient was eventually diagnosed with Hodgkin’s lymphoma based on lymph node biopsy but died during chemotherapy. Physicians should prioritize the tests that are most directly related to the diagnostic outcome, even if they are invasive.

scholarly journals Sentinel bruising as a presentation of metastatic melanoma

2019 ◽  
Vol 12 (2) ◽  
pp. e228114 ◽  
Author(s):  
Lloyd Steele ◽  
Chit Cheng Yeoh
Keyword(s):  
Weight Loss ◽  
Skin Lesions ◽  
Lymph Node Biopsy ◽  
Cutaneous Malignant Melanoma ◽  
Subcutaneous Nodule ◽  
Rare Presentation ◽  
Subcutaneous Nodules ◽  
Node Biopsy ◽  
Melanoma Metastases ◽  
History Of

A 46-year-old man presented with a 4-week history of bruising with subcutaneous nodules and weight loss. He also had a 2-week history of progressive back and hip pain. He had been diagnosed with stage Ib cutaneous melanoma 30 months previously, which had been fully excised. A sentinel lymph node biopsy was negative. On examination, there were five skin lesions at different stages. Each had spontaneously appeared as a bruise with a central subcutaneous nodule, and the bruising then faded to leave a persistent subcutaneous nodule. Excision of one of the nodules demonstrated a 4.5 mm diameter partly necrotic melanoma deposit in the dermis. CT scan of the head, chest, abdomen and pelvis showed widespread metastases. This rare presentation of cutaneous malignant melanoma metastases has been termed ‘sentinel bruising’. There are fewer than 10 cases reported in the literature.

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