Kikuchi Syndrome: A Rare Occurrence

BACKGROUND: Here, we report a rare case of Kikuchi syndrome. An African American male patient was evaluated extensively for nonspecific constitutional symptoms and lymphadenopathy. Histopathology confirmed the diagnosis of Kikuchi syndrome.
CASE REPORT: A 64-year-old African American male patient was admitted with recurrent fevers, weight loss, body aches, and generalized lymphadenopathy. Initial suspicion was high in favor of hematological malignancies versus other visceral malignancies. Acute HIV syndrome was also suspected. Leukopenia and a slightly elevated ALK were the only abnormal lab results. Whole-body imaging was negative for cancers. HIV testing and hepatitis serology were negative. Serum QuantiFERON-TB and viral titers were also negative.
Axillary lymph node biopsy was finally positive for focal necrosis, histiocytic proliferation, and polyclonal plasmacytosis. He was managed with NSAIDs and never had a recurrence.
CONCLUSIONS: Kikuchi histiocytic necrotizing lymphadenitis is a rare, benign, inflammatory condition of unknown cause usually characterized by cervical lymphadenopathy and fever. The female-to-male ratio is 4: 1. Fever, weight loss, generalized lymphadenopathy, and joint pains are a few of the nonspecific constitutional symptoms. Since this is a diagnosis of exclusion, histopathology is mandatory for diagnosis.

Keywords: Fever, Histiocytic Necrotizing Lymphadenitis, Immunoblastic Lymphadenopathy, Weight Loss