A rare and interesting case report of Kikuchi-Fujimoto disease masquerading as tuberculosis

Kikuchi-Fujimoto disease (KFD), or histiocytic necrotizing lymphadenitis, is a rare benign, self-limited condition, probably genetic, that mainly affects young women which often presents with localised lymphadenopathy and fever. Reporting the case of a 17-year-old girl, with a strong family history of tuberculosis, who presented to the surgery OPD with cervical lymphadenopathy and a history of anti-tubercular treatment for the same complaints two years back. An excision biopsy revealed necrotizing histiocytic lymphadenitis suggestive of KFD. Post-operative period was uneventful and patient had spontaneous resolution of her complaints upon follow up. It is quite difficult to make a pre-operative diagnosis of this disease, until the clinician has got a very high index of suspicion especially because of the more common differential diagnoses including extrapulmonary tuberculosis.

Peripheral lymphadenopathy and FNA: a two-year evaluation at a tertiary care centre

Background: Lymphadenopathy is an age old affliction of mankind and a very common presentation in clinical practice. The main purpose of an FNA biopsy of abnormal peripheral lymph nodes is to determine whether further surgical excision of the lymph node is indicated for histopathological examination. The aim of the present study was to evaluate the role of fine needle aspiration cytology in patients with superficial lymphadenopathy and to correlate with histopathology wherever possible.Methods: A two-year study was undertaken at the Central Diagnostic Laboratory at A.J. Institute of Medical Sciences, Mangalore. Patients of all age groups referred to the Central Diagnostic Laboratory for FNA of superficial lymph nodes were included in the study. All the slides of the cases were reviewed and impression recorded.Results: Out of 200 cases, 73% were non neoplastic, 27% were neoplastic. Cases occurred most commonly in age group of 21-30 years. The male to female ratio was 1.7:1 and most common site of lymph node aspiration was cervical lymph node in (n =107) 53.5% cases. Reactive hyperplasia was the most common non- neoplastic cause of lymphadenopathy seen in 34.5% cases and metastasis to lymph node was the most common cause of neoplastic lymphadenopathy seen in 22% of the cases. The sensitivity was 90%, specificity was 100% and accuracy was 96.2%.Conclusions: FNA is a very efficient, simple, safe, inexpensive and economical test for detecting the various causes of lymphadenopathy.