DefinePK

Research Objective

To present six cases of cervical lymphadenopathy diagnosed as Kikuchi's disease and to raise the index of suspicion for this disease.

Methodology

Case Series study conducted at the Histopathology and Otolaryngology/Head & Neck Surgery Departments at Rehman Medical Institute (RMI) Peshawar from July 2016 to March 2021. Records of patients diagnosed with "histiocytic necrotising lymphadenitis" were retrieved, patient files accessed, and case notes analyzed. Histopathology slides were reviewed and re-confirmed.

Methodology Flowchart

                        graph TD;
    A[Retrieve records of 'histiocytic necrotising lymphadenitis'] --> B[Access patient files and analyze case notes];
    B --> C[Pathologist re-confirms slides];
    C --> D[Collect relevant data from case notes];
    D --> E[Present findings and analyze results];
    E --> F[Formulate conclusion and discussion];                    

Discussion

Kikuchi's disease is an increasingly recognized, self-limiting cervical lymphadenitis of unknown origin, predominantly affecting young women. While the exact cause is unknown, autoimmune and infections are considered. The gold standard for diagnosis is lymph node biopsy. The disease can mimic malignant lymphoma, leading to potential misdiagnosis. It is generally benign and self-limiting, with symptomatic treatment being the mainstay.

Key Findings

Six cases of Kikuchi's disease were presented, with a female predominance (2:1 ratio). All patients had palpable neck lymph nodes, predominantly on the left (66.7%). A majority (66.7%) experienced neuralgic pain. All but one patient had weight loss and night sweating. All patients recovered spontaneously within 6 months with symptomatic treatment for pain.

Conclusion

Kikuchi's disease should be considered in the differential diagnosis for young females presenting with persistent neck masses, palpable lymph nodes, and suspicious fine needle aspiration cytology (FNAC). Excision biopsy is crucial for confirmation and to rule out lymphoma. Symptomatic treatment is generally sufficient for this benign condition.

Fact Check

1. Kikuchi's disease was first described in 1972 by Masahiro Kikuchi and Fujimoto. (Confirmed in text)
2. The study presented six cases of Kikuchi's disease. (Confirmed in text)
3. All six patients recovered spontaneously within 6 months with symptomatic treatment for neuralgic pain. (Confirmed in text)

Mind Map