Rc Adhikari

Kikuchi-Fujimoto Disease in Nepal A Study of 6 Cases

CONTEXT Kikuchi-Fujimoto disease is a benign disorder, predominantly affecting young women with a predilection for cervical lymphadenopathy. Although the disease has been recognized worldwide, to our knowledge no cases have been reported previously from Nepal. OBJECTIVES To determine the prevalence of Kikuchi-Fujimoto disease in Nepal and to analyze clinicopathologic features. METHODS We reviewed 6 cases of Kikuchi-Fujimoto disease recorded at 3 different hospitals in Nepal during a period from June 1998 to June 2002. Clinical data and histopathology are presented. RESULTS This study included 5 females and 1 boy, aged 13 to 32 years. These patients presented with prolonged fever and lymphadenopathy. The 5 female patients had cervical lymphadenopathy, and the boy had axillary lymphadenopathy. Complete blood counts revealed raised erythrocyte sedimentation rates in all patients and anemia in 2 patients. The size of excised lymph nodes (in greatest dimension) ranged from 1.5 to 5 cm. Typical histologic features were seen, namely, architectural effacement due to presence of pale nodular lymphohistiocytic foci with karyorrhectic debris, coagulation necrosis, eosinophilic debris, and absence of granulocytic infiltration. In a follow-up of the cases, disease recurrence was not found. CONCLUSION Our study emphasizes that Kikuchi-Fujimoto disease should be considered as one of the differential diagnoses in patients with prolonged fever and cervical lymphadenopathy and that it should be differentiated from tuberculous lymphadenitis in regions where tuberculosis is prevalent.

A clinicopathologic study of melanocytic neoplasms

Background and objectives: This study reports baseline information about melanocytic neoplasms in TUTH. The objective was to study the histological spectrum of melanocytic nevi and melanoma, and to make a clinicohistopathological correlation. Methods: 50 consecutive cases of melanocytic neoplasms were studied from December 2010 to December 2011. Results: Of the 50 cases, 12 (24%) were malignant melanoma and 38 (76%) were melanocytic nevi. Cutaneous melanocytic nevi was the most common, 30/38 (79%), followed by 8/38 (21%) conjunctival nevi. Head and neck was the most common site (25/38) and the mean age at presentation was 32.66+16.19 years, the female to male ratio being 5.3:1. In melanoma, 4 (33%) were extracutaneous, of the cutaneous, 2 (17%) were acral lentiginous, and 6 (50%) were nodular. Mean age was 50+16.99 years with an equal female to male ratio. The most common site was the extremities (6/8) in cutaneous lesions and choroid in extracutaneous (2/4) lesions. Concordance between clinical and histopathological diagnosis was found in 30/50 (60%) cases. Conclusion: Melanocytic nevi are quite common in females. Melanoma is rare, affecting men and women equally. In our context, melanoma likely represents a sporadic disorder. Difference from the western societies is the common occurrence of nodular melanoma here and the topographical distribution.