Kikuchi Fujimoto disease (KFD), otherwise called histiocytic necrotizing lymphadenitis
is an uncommon, idiopathic disease affecting Japanese and east Asian individuals more commonly with a male to female ratio of 1:4.1-5.
Histologic Differential Diagnosis of Kikuchi-Fujimoto Disease Infections Tuberculosis Histoplasmosis Leprosy Cat-scratch disease Syphilis Yersinia enterocolitica lymphadenitis
, not otherwise specified Herpes simplex lymphadenitis
Infectious mononucleosis Autoimmune diseases Systemic lupus erythematosus Lymphomas B-cell non-Hodgkin lymphoma (eg, diffuse large B-cell lymphoma) T-cell non-Hodgkin lymphoma (eg, peripheral T-cell lymphoma, anaplastic large cell lymphoma) Classical Hodgkin lymphoma Myeloid sarcoma HISTOPATHOLOGIC FEATURES AND IMMUNOHISTOCHEMISTRY
Although BCG is a safe and widely accepted vaccine, it sometimes causes local adverse reaction such as regional lymphadenitis
, local abscess formation, osteomyelitis, and rarely disseminated mycobacterial infection.
Keywords: Suppurative Bacillus Calmette Guerin lymphadenitis
, needle aspiration, surgical excision, Bacillus Calmette Guerin vaccine.
Suture granuloma can mimic tuberculous lymphadenitis
. The initial decision to initiate anti-TB medication was based on the histopathological finding of a granuloma.
Extrapulmonary tuberculosis, 43% of which showed preliminary findings with peripheral LAP, is the most common form of tuberculous lymphadenitis
Almost similar results are reported in a study conducted in Kathmandu, in which causes of cervical lymphadenopathy were tuberculous lymphadenitis
(54%), reactive hyperplasia (33%) and metastatic lesion in lymph nodes (11.1%).15 Our reports are in tandem with another local study in which out of total 220 patients with enlarged neck lymph nodes, tuberculous lymphadenitis
was the most common occurrence (70.45%).16,17 All of the tuberculous patients studied by Chaudry N, 58% presented with cervical adenitis.17
The study exclusively included patients with TB lymphadenitis
and Stage 1 sarcoidosis patients, and hence, no difference in NLR between the groups could be revealed.
Histology in granulomatous lymphadenitis
is characterized by scattered small epithelioid granulomas with a sparse arrangement of epithelioid cells and accompanying lymphocytic infiltrate among granuloma cells .
Among the 42 benign pathologies, 16 were sarcoidosis, 17 were tuberculosis, eight were lymphadenitis
, and one was Castleman disease.
The patient was initially started on IVIG and high-dose aspirin as well as IV clindamycin as empiric therapy for lymphadenitis
. Careful physical examination revealed a small 1 x 1 cm scab on the scalp (Figure 2).
Similarly, the findings of sinus histiocytosis was comparable between both the groups, while cat-scratch disease and acute lymphadenitis
were more common in adults.
is found in 60% of CGD patients, having the second highest rate next to lung infection, while Staphylococcus aureus is the most common pathogen for this infection.
These findings were consistent with necrotizing lymphadenitis
is the most common form of extrapulmonary tuberculosis.