[Kikuchi lymphadenitis. A contribution to the differential diagnosis of cervical lymph node swelling of unknown origin]

Abstract

According to its morphological appearance, Kikuchi's disease is also called "histiocytic necrotizing lymphadenitis". This disorder was first described in Japan in 1972 as a benign lymphadenopathy of the neck. In Germany only a few cases have been reported by pathologists, whereas most clinicians are unaware of the existence of this rare disease, which can easily be mistaken for malignant lymphoma. In 1993 three cases of Kikuchi's lymphadenitis were treated at the ENT Department of the University of Lübeck. Patients' ages ranged from 15 to 30 years old. Except for cervical adenopathy, findings in blood tests, viral serology and radiological imaging were unremarkable. While fine needle aspirations were suspicious for malignant lymphoma, a final diagnosis of self-limiting "Kikuchi's lymphadenitis" was established histologically from excised lymph nodes. In our opinion early extirpation of lymph nodes and consultation of a pathologist are necessary to make a correct diagnosis without delay. Thus, in patients with Kikuchi's lymphadenitis unnecessary staging procedures and treatment can be avoided.