Necrotizing lymphadenitis with generalized adenopathy: A diagnostic dilemma – Kikuchi–Fujimoto disease

Abstract

Kikuchi–Fujimoto disease (KFD) is a rare, self-limiting, benign disorder of lymphoreticular system that commonly occurs in young Asian women predominantly under <30 years of age. Clinically, it presents as cervical lymphadenopathy, fever, and weight loss; therefore, it is a disease of exclusion in countries such as India, which are endemic for tuberculosis. Here, we are describing a case of a young female who again presented with low-grade fever and arthralgia; 1 month after the completion of 6-month antitubercular treatment. In view of generalized lymphadenopathy, raised erythrocyte sedimentation rate; clinical, radiological, and fluorodeoxyglucose positron emission tomography-computed tomography scan findings; and the differentials diagnoses of disseminated tuberculosis, lymphoma, or sarcoidosis were considered. Histopathology of the right axillary lymph node showed paracortical expansion by histiocytes, necrosis, numerous apoptotic debris, and paucity of plasma cells with the absence of neutrophils, thus confirming the diagnosis of KFD. The correct diagnosis thus helped to relieve the anxiety of the patient and prevented unnecessary medication.