Answer to CC #5

Tough case this week! Case Challenge #5 presented a 28 yo female with fever, cervical LAD, and atypical lymphs.  Biopsy revealed necrotizing lymphadenitis with histiocytes, nuclear debris, and negative organism stains.

 Which is the most likely diagnosis?

The correct answer is:

Kikuchi’s Disease

  • Benign disease of young (women) with acute fevers and unilateral cervical LAD (esp posterior)
  • Associated with uveitis, aseptic meningitis, HSM, rash and arthritis
  • Often leukopenic with atypical lymphs
  • Dx by biopsy showing preserved architecture, necrotizing histiocytic infiltrate with phagocytosed nuclear debris

Great job! Look forward to a easier case challenge next week 🙂