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Rare disease
CASE REPORT
Persistent cervical lymphadenitis in a patient with prior thyroid cancer attributed to Kikuchi-Fujimoto disease
  1. Roman Zuckerman1,
  2. Louise Damiani2,
  3. Hashem A Ayyad3,
  4. Deborah R Alpert4
  1. 1Rheumatology, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA
  2. 2Medicine/Oncology, Jersey Shore University Medical Center, Neptune, New Jersey, USA
  3. 3Pathology, Jersey Shore University Medical Center, Neptune, New Jersey, USA
  4. 4Medicine/Rheumatology, Jersey Shore University Medical Center, Neptune, New Jersey, USA
  1. Correspondence to Dr Deborah R Alpert, Deborah.Alpert{at}hackensackmeridian.org

Summary

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.

  • connective tissue disease
  • malignant and benign haematology

https://doi.org/10.1136/bcr-2018-226457

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    Footnotes

    • Contributors RZ: conception and design, acquisition of data, analysis and interpretation of data, drafting the article, revising it critically for important intellectual content. LD: drafting the article, revising it critically for important intellectual content. HAA: revising the article critically for important intellectual content. DRA: conception and design, acquisition of data, analysis and interpretation of data, drafting the article, revising it critically for important intellectual content. RZ, LD, HAA and DRA: final approval of the version published. Agreement to be accountable for the article and to ensure that all questions regarding the accuracy or integrity of the article are investigated and resolved.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Patient consent Obtained.

    • Provenance and peer review Not commissioned; externally peer reviewed.