Kikuchi-Fujimoto disease (KFD) (also known as subacute necrotising lymphadenitis or subacute necrotising histiocytosis) is an idiopathic disease characterised usually by cervical lymph node enlargement (80%).
It typically affects young women.
It usually presents clinically with cervical lymphadenopathy that is sometimes tender. Accompanying systemic symptoms include low-grade fever, night sweats, malaise and joint or abdominal pains resembling a viral illness 3,4.
The cause is unknown and debated, with both viral infection and autoimmune mediated mechanisms proposed in the literature.
Typically (~80%) a single nodal group is involved, most frequently (70%) the posterior triangle. The nodes are soft and sometimes tender.
Imaging findings are non-specific and demonstrate primarily cervical nodal enlargement. The modality used depends on the suspected differential diagnoses at the time of presentation.
A review of CT neck findings in patients with Kikuchi disease to characterise nodal findings showed 6:
- homogenous nodal enlargement (83%)
- perinodal infiltration (80%)
- central nodal necrotic change (16%)
Post-contrast enhancement has been reported.
Treatment and prognosis
It usually runs a benign course that is self limiting with most lymph nodes returning to normal size within the first six months of diagnosis.
- kimura disease: painful lymphadenopathy
- 1. Kwon SY, Kim TK, Kim YS et-al. CT findings in Kikuchi disease: analysis of 96 cases. AJNR Am J Neuroradiol. 25 (6): 1099-102. AJNR Am J Neuroradiol (full text) - Pubmed citation
- 2. Martínez-vázquez C, Hughes G, Bordon J et-al. Histiocytic necrotizing lymphadenitis, Kikuchi-Fujimoto's disease, associated with systemic lupus erythemotosus. QJM. 1997;90 (8): 531-3. doi:10.1093/qjmed/90.8.531 - Pubmed citation
- 3. Haaga JR, Boll D. CT and MRI of the whole body. Mosby. (2009) ISBN:0323053750. Read it at Google Books - Find it at Amazon
- 4. Bosch X, Guilabert A. Kikuchi-Fujimoto disease. Orphanet J Rare Dis. 2007;1 (1): 18. doi:10.1186/1750-1172-1-18 - Free text at pubmed - Pubmed citation
- 5. Mahajan T, Merriman RC, Stone MJ. Kikuchi-Fujimoto disease (histiocytic necrotizing lymphadenitis): report of a case with other autoimmune manifestations. Proc (Bayl Univ Med Cent). 2011;20 (2): 149-51. Free text at pubmed - Pubmed citation
- 6. Kwon SY, Kim TK, Kim YS, et al. CT findings in Kikuchi disease: analysis of 96 cases. AJNR. 2004;25 (6):1099-102. Free text at AJNR - Pubmed citation