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Case Reports
. 2018 Oct 21:2018:bcr2018226457.
doi: 10.1136/bcr-2018-226457.

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

Roman Zuckerman  1 , Louise Damiani  2 , Hashem A Ayyad  3 , Deborah R Alpert  4
Affiliations
Case Reports

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

Roman Zuckerman et al. BMJ Case Rep. .

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.

Keywords: connective tissue disease; malignant and benign haematology.

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
Bilateral cervical lymphadenopathy, left greater than right.
Figure 2
Figure 2
Excisional lymph node biopsy. A well-formed granuloma with central caseation.
Figure 3
Figure 3
CT neck with contrast. Bilateral cervical lymphadenopathy, yellow arrows. Status-post thyroidectomy.
See this image and copyright information in PMC

References

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