Kurahara Yu, Tachibana Kazunobu, Tezuka Kenji, Shimizu Shigeki, Kitaichi Masanori, Hayashi Seiji, Suzuki Katsuhiro
Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Japan.
Intern Med. 2012;51(14):1927-30. doi: 10.2169/internalmedicine.51.7574. Epub 2012 Jul 15.
A 28-year-old woman was referred to our hospital for treatment of tuberculous lymphadenitis, after presenting with fever, left cervical lymphadenopathy, and a positive interferon-gamma release assay (QuantiFERON®-TB Gold In-Tube; QFT) result. Surprisingly, biopsy specimens of the cervical lymph nodes showed necrotic lesions with prominent nuclear debris and a proliferation of histiocytes, consistent with Kikuchi-Fujimoto disease (KFD). A diagnosis was made of KFD complicated by latent tuberculosis infection (LTBI), and all symptoms had resolved completely two months post-diagnosis. KFD may be misdiagnosed as tuberculous lymphadenitis, and antibiotics unnecessarily prescribed. Careful attention should therefore be paid when diagnosing cervical lymphadenopathy.
一名28岁女性因发热、左侧颈部淋巴结肿大以及干扰素-γ释放试验(QuantiFERON®-TB Gold In-Tube;QFT)结果呈阳性,被转诊至我院治疗结核性淋巴结炎。令人惊讶的是,颈部淋巴结活检标本显示坏死性病变,伴有明显的核碎片和组织细胞增生,符合菊池-藤本病(KFD)。诊断为KFD合并潜伏性结核感染(LTBI),诊断后两个月所有症状完全缓解。KFD可能被误诊为结核性淋巴结炎,并被不必要地使用抗生素。因此,在诊断颈部淋巴结病时应予以仔细关注。