engleski

Kikuchi-Fujimoto Disease: Early Diagnosis with FNAC

Background: Kikuchi-Fujimoto disease (KFD) or histiocytic necrotizing lymphadenitis is very rare, benign enlargment of the lymph nodes. It usually present with fever, lymphadenopathy, skin rash and headache. The KFD has benign and self-limiting course. The accurate diagnosis of KFD on fine-needle aspiration cytology (FNAC) is possible on adequately sampled and well prepared specimen complemented with full and accurate clinical data. Case: An 18-year old female presented with painful, progressive enlargement of subangular lymph nodes, fever (up 39.7 C), headache, sore throat and skin rash (above elbow and knee). On admission the patient was febrile (38.9 C) with 2.2 cm and 1.5 cm large, left subangilar, hard, movable and painfull lymph nodes. Laboratory studies revealed only elevated erythrocyte sedimentation rate and C-reactive protein. FNAC of lymph nodes showed karyorrhectic and granular debris, crescentic histiocytes and plasmacytoid monocytes on reactive lymphoid background. Imunocytochemically, crescentic histiocytes were expressed MPO and CD68, plasmacytoid monocytes were positive for CD68, but not for MPO. Cytological and immunocytochemical findings confirmed definitive diagnosis of KFD. Lymph node flow cytometry showed polyclonal lymphocyte population. Additional serologic test for parvovirus B19 was positive, while test for EBV, CMV, toxoplasmosis and adenovirus were negative. Several weeks later the patient is well without any signs of local and systemic disease. Conclusion: Differential diagnosis of KFD includes lymphoma, TBC lymphadenitis and lupus lymphadenopathy. An early FNAC diagnostic prevents unnecessary procedures and potentially harmful treatments.

FNAC; Kikuchi-Fujimoto disease

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