Two Cases of an Enigmatic Entity: Kikuchi’s Disease

Abstract

Background: Kikuchi’s disease [KD] is a self-limited rare disorder characterized by necrotizing lymphadenopathy in
especially women with a mean age of 27.4 years. It mostly arises in the posterior cervical triangle. Lympadenopathy may be
accompanied by fever, chills, myalgias, arthralgias, splenomegaly, hepatomegaly and/or skin rashes. KD’s etiology is
unknown, and it is commonly misdiagnosed as lymphoma. Herein, we present two cases of KD consulted to our institute in
two weeks period.
Case Presentations: The first case was a 41 year-old male presented with a posterior cervical lymphadenopathy of
2x1.7x1 cm in size. The second case was a 33 year-old female presented with a left axillary lymphadenopathy of 1.5x1x1 cm in
size. The paraffin blocks of lymph node biopsies were evaluated. Similar findings were detected in both cases, and the
diagnoses of KD were reached microscopically. There were multiple foci of patchy necrosis. Necrotic foci were composed of
nuclear dusts phagocytosed by numerous histiocytes with crescentic nuclei that were positive for myeloperoxidase
immunohistochemically. Numerous immunoblasts with atypical nuclei were detected.
Discussion: It should be noted that discriminating KD from systemic lupus erytematosus [SLE], cat-scratch disease, and
particularly some lymphomas showing necrosis in the lymph nodes is usually difficult. A brief summary about the
clinicopathological characteristics and clues about the differential diagnosis of KD are given in this report with two
demonstrative cases in order to contribute a better understanding of this rare enigmatic entity.