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Histiocytic Necrotizing Lymphadenitis (Kikuchi-Fujimoto)
Luke N. Ledbetter, MD; Sara Strauss, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Histiocytic necrotizing lymphadenitis (HNL)
              • Synonyms

                • Kikuchi disease
                • Kikuchi-Fujimoto disease
              • Definitions

                • Benign, idiopathic, necrotizing cervical adenitis more common in young Asian adults

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Microscopic Features

                                CLINICAL ISSUES

                                • Presentation

                                  • Demographics

                                    • Natural History & Prognosis

                                      • Treatment

                                        DIAGNOSTIC CHECKLIST

                                        • Consider

                                          • Image Interpretation Pearls

                                            Selected References

                                            1. Park SG et al: Efficacy of ultrasound-guided needle biopsy in the diagnosis of Kikuchi-Fujimoto disease. Laryngoscope. 131(5):E1519-23, 2021
                                            2. You SH et al: Cervical necrotic lymphadenopathy: a diagnostic tree analysis model based on CT and clinical findings. Eur Radiol. 29(10):5635-45, 2019
                                            3. Kang HM et al: Clinical characteristics of severe histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto Disease) in children. J Pediatr. 171:208-212.e1, 2016
                                            4. Dumas G et al: Kikuchi-Fujimoto disease: retrospective study of 91 cases and review of the literature. Medicine (Baltimore). 93(24):372-82, 2014
                                            5. Ludwig BJ et al: Imaging of cervical lymphadenopathy in children and young adults. AJR Am J Roentgenol. 199(5):1105-13, 2012
                                            6. Tsujikawa T et al: Kikuchi-Fujimoto disease: PET/CT assessment of a rare cause of cervical lymphadenopathy. Clin Nucl Med. 36(8):661-4, 2011
                                            7. Cunha BA et al: Fever of unknown origin (FUO) caused by Kikuchi's disease mimicking lymphoma. Heart Lung. 38(5):450-6, 2009
                                            8. Ito K et al: F-18 FDG PET/CT findings showing lymph node uptake in patients with Kikuchi disease. Clin Nucl Med. 34(11):821-2, 2009
                                            9. Lee DH et al: Disseminated Kikuchi-Fujimoto disease mimicking malignant lymphoma on positron emission tomography in a child. J Pediatr Hematol Oncol. 31(9):687-9, 2009
                                            10. Nomura Y et al: Phenotype for activated tissue macrophages in histiocytic necrotizing lymphadenitis. Pathol Int. 59(9):631-5, 2009
                                            11. Pilichowska ME et al: Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease): lesional cells exhibit an immature dendritic cell phenotype. Am J Clin Pathol. 131(2):174-82, 2009
                                            12. Chase SP et al: Cervical lymphadenopathy secondary to Kikuchi-Fujimoto disease in a child: case report. Ear Nose Throat J. 87(6):350-3, 2008
                                            13. Kaicker S et al: PET-CT scan in a patient with Kikuchi disease. Pediatr Radiol. 38(5):596-7, 2008
                                            14. Kampitak T: Fatal Kikuchi-Fujimoto disease associated with SLE and hemophagocytic syndrome: a case report. Clin Rheumatol. 27(8):1073-5, 2008
                                            15. Pace-Asciak P et al: Case series: raising awareness about Kikuchi-Fujimoto disease among otolaryngologists: is it linked to systemic lupus erythematosus? J Otolaryngol Head Neck Surg. 37(6):782-7, 2008
                                            16. Papla B et al: Histiocytic necrotizing lymphadenitis without granulocytic infiltration (the so called Kikuchi-Fujimoto disease). Pol J Pathol. 59(1):55-61, 2008
                                            17. Youk JH et al: Sonographic features of axillary lymphadenopathy caused by Kikuchi disease. J Ultrasound Med. 27(6):847-53, 2008
                                            18. Kwon SY et al: CT findings in Kikuchi disease: analysis of 96 cases. AJNR Am J Neuroradiol. 25(6):1099-102, 2004
                                            19. Na DG et al: Kikuchi disease: CT and MR findings. AJNR Am J Neuroradiol. 18(9):1729-32, 1997
                                            Related Anatomy
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                                            Related Differential Diagnoses
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                                            References
                                            Tables

                                            Tables

                                            KEY FACTS

                                            • Terminology

                                              • Imaging

                                                • Top Differential Diagnoses

                                                  • Pathology

                                                    • Clinical Issues

                                                      • Diagnostic Checklist

                                                        TERMINOLOGY

                                                        • Abbreviations

                                                          • Histiocytic necrotizing lymphadenitis (HNL)
                                                        • Synonyms

                                                          • Kikuchi disease
                                                          • Kikuchi-Fujimoto disease
                                                        • Definitions

                                                          • Benign, idiopathic, necrotizing cervical adenitis more common in young Asian adults

                                                        IMAGING

                                                        • General Features

                                                          • CT Findings

                                                            • MR Findings

                                                              • Ultrasonographic Findings

                                                                • Nuclear Medicine Findings

                                                                  • Imaging Recommendations

                                                                    DIFFERENTIAL DIAGNOSIS

                                                                      PATHOLOGY

                                                                      • General Features

                                                                        • Microscopic Features

                                                                          CLINICAL ISSUES

                                                                          • Presentation

                                                                            • Demographics

                                                                              • Natural History & Prognosis

                                                                                • Treatment

                                                                                  DIAGNOSTIC CHECKLIST

                                                                                  • Consider

                                                                                    • Image Interpretation Pearls

                                                                                      Selected References

                                                                                      1. Park SG et al: Efficacy of ultrasound-guided needle biopsy in the diagnosis of Kikuchi-Fujimoto disease. Laryngoscope. 131(5):E1519-23, 2021
                                                                                      2. You SH et al: Cervical necrotic lymphadenopathy: a diagnostic tree analysis model based on CT and clinical findings. Eur Radiol. 29(10):5635-45, 2019
                                                                                      3. Kang HM et al: Clinical characteristics of severe histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto Disease) in children. J Pediatr. 171:208-212.e1, 2016
                                                                                      4. Dumas G et al: Kikuchi-Fujimoto disease: retrospective study of 91 cases and review of the literature. Medicine (Baltimore). 93(24):372-82, 2014
                                                                                      5. Ludwig BJ et al: Imaging of cervical lymphadenopathy in children and young adults. AJR Am J Roentgenol. 199(5):1105-13, 2012
                                                                                      6. Tsujikawa T et al: Kikuchi-Fujimoto disease: PET/CT assessment of a rare cause of cervical lymphadenopathy. Clin Nucl Med. 36(8):661-4, 2011
                                                                                      7. Cunha BA et al: Fever of unknown origin (FUO) caused by Kikuchi's disease mimicking lymphoma. Heart Lung. 38(5):450-6, 2009
                                                                                      8. Ito K et al: F-18 FDG PET/CT findings showing lymph node uptake in patients with Kikuchi disease. Clin Nucl Med. 34(11):821-2, 2009
                                                                                      9. Lee DH et al: Disseminated Kikuchi-Fujimoto disease mimicking malignant lymphoma on positron emission tomography in a child. J Pediatr Hematol Oncol. 31(9):687-9, 2009
                                                                                      10. Nomura Y et al: Phenotype for activated tissue macrophages in histiocytic necrotizing lymphadenitis. Pathol Int. 59(9):631-5, 2009
                                                                                      11. Pilichowska ME et al: Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto disease): lesional cells exhibit an immature dendritic cell phenotype. Am J Clin Pathol. 131(2):174-82, 2009
                                                                                      12. Chase SP et al: Cervical lymphadenopathy secondary to Kikuchi-Fujimoto disease in a child: case report. Ear Nose Throat J. 87(6):350-3, 2008
                                                                                      13. Kaicker S et al: PET-CT scan in a patient with Kikuchi disease. Pediatr Radiol. 38(5):596-7, 2008
                                                                                      14. Kampitak T: Fatal Kikuchi-Fujimoto disease associated with SLE and hemophagocytic syndrome: a case report. Clin Rheumatol. 27(8):1073-5, 2008
                                                                                      15. Pace-Asciak P et al: Case series: raising awareness about Kikuchi-Fujimoto disease among otolaryngologists: is it linked to systemic lupus erythematosus? J Otolaryngol Head Neck Surg. 37(6):782-7, 2008
                                                                                      16. Papla B et al: Histiocytic necrotizing lymphadenitis without granulocytic infiltration (the so called Kikuchi-Fujimoto disease). Pol J Pathol. 59(1):55-61, 2008
                                                                                      17. Youk JH et al: Sonographic features of axillary lymphadenopathy caused by Kikuchi disease. J Ultrasound Med. 27(6):847-53, 2008
                                                                                      18. Kwon SY et al: CT findings in Kikuchi disease: analysis of 96 cases. AJNR Am J Neuroradiol. 25(6):1099-102, 2004
                                                                                      19. Na DG et al: Kikuchi disease: CT and MR findings. AJNR Am J Neuroradiol. 18(9):1729-32, 1997