Visible Lymphadenopathy in Kikuchi-Fujimoto Disease

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Figure 1

Visible right cervical lymphadenopathies in the posterior cervical triangle.

Figure 2

Cervical lymph-node excisional biopsies revealed increased CD 68+ histiocytes (a), lymphocytes, and immunoblasts in the cortices with abundant karyorrhectic debris (b).

An otherwise healthy 11-year-old Japanese boy presented with a 3-week history of a right neck mass. Except for mild fatigue, he did not display any associated general symptoms, including fever, night sweats, or weight loss. Physical examination demonstrated a prominent tender cervical lymphadenopathy in the posterior cervical triangle (Figure 1). Blood tests reported leukopenia and mildly elevated lactate dehydrogenase and aminotransferase levels. Over the following two weeks, his lymph nodes enlarged and his fatigue worsened; thus, we performed a cervical lymph-node excisional biopsy that revealed increased CD 68+ histiocytes, lymphocytes, and immunoblasts in the cortices with abundant karyorrhectic debris (Figure 2); these findings were compatible with Kikuchi–Fujimoto disease (KFD).

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