Persistent cervical lymphadenitis in a patient with prior thyroid cancer attributed to Kikuchi-Fujimoto disease.

Abstract

We describe a 50-year-old woman with a history of thyroid cancer who presented with bilateral cervical and submandibular lymphadenopathy, low-grade fevers, and increasing fatigue. The patient underwent lymph node fine-needle aspiration, which showed no evidence of metastatic or lymphoproliferative disease. This procedure was complicated by a parapharyngeal abscess and cellulitis. She was treated unsuccessfully with various courses of antibiotics, but briefly responded to short courses of steroids. As her cervical lymphadenopathy returned, she underwent an excisional lymph node biopsy, which demonstrated caseating granulomatous lymphadenitis. Extensive review of systems, physical examination, laboratory and imaging studies demonstrated no evidence of malignancy, infection or systemic lupus erythematosus . Our patient was clinically diagnosed with Kikuchi-Fujimoto disease and successfully treated with prednisone tapered over 3 months. She remains in clinical remission.

• Authors: Roman Zuckerman, Louise Damiani, Hashem A Ayyad, Deborah R Alpert
• Journal: BMJ case reports (BMJ Case Rep) Vol. 2018 (Oct 21 2018) ISSN: 1757-790X [Electronic] England
• PMID: 30344150 (Publication Type: Case Reports, Journal Article)
• Copyright: © BMJ Publishing Group Limited 2018. No commercial re-use. See rights and permissions. Published by BMJ.

Chemical References

• Anti-Inflammatory Agents
• Prednisone

Topics

• Anti-Inflammatory Agents (therapeutic use)
• Biopsy, Fine-Needle
• Diagnosis, Differential
• Fatigue (etiology)
• Female
• Histiocytic Necrotizing Lymphadenitis (complications, diagnosis, drug therapy, pathology)
• Humans
• Middle Aged
• Neck
• Prednisone (therapeutic use)
• Thyroid Neoplasms