Department of Nuclear Medicine, 159407The First Hospital of China Medical University, The First Hospital of China Medical University, Shenyang, P.R. China.
J Int Med Res. 2021 Jul;49(7):3000605211032859. doi: 10.1177/03000605211032859.
Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a benign, self-limiting inflammatory disorder of unknown etiology and pathogenesis. This report presents a rare case involving a man with F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET/CT) hypermetabolism caused by KFD mimicking malignant lymphoma. The PET/CT maximum intensity projection showed multiple hypermetabolic lymphadenopathies and homogeneous FDG uptake in the bone marrow and spleen. Malignant lymphoma was initially suspected. The patient then underwent excision biopsy of one enlarged right cervical lymph node that was selected because it showed the highest FDG uptake in PET/CT, and examination of this biopsy specimen confirmed the diagnosis of KFD. PET/CT is useful for assessing the general condition of patients and can help to select lymph nodes for excision biopsy based on the highest FDG uptake. However, KFD can predispose to localized FDG uptake and limit the specificity of PET/CT by mimicking malignancy. Thus, positive results of PET/CT should be interpreted with caution.
菊池-藤本病（Kikuchi-Fujimoto disease，KFD），又称组织细胞性坏死性淋巴结炎，是一种病因和发病机制不明的良性、自限性炎症性疾病。本报告介绍了一例罕见病例，患者 F-氟代脱氧葡萄糖正电子发射断层扫描/计算机断层扫描（fluorodeoxyglucose positron emission tomography/computed tomography，FDG PET/CT）示因 KFD 导致的高代谢，类似于恶性淋巴瘤。PET/CT 最大强度投影显示多发高代谢淋巴结病，骨髓和脾脏呈均匀 FDG 摄取。最初怀疑为恶性淋巴瘤。然后，患者接受了切除活检，选择了在 PET/CT 中 FDG 摄取最高的一个右侧颈淋巴结进行切除活检，该活检标本的检查结果证实了 KFD 的诊断。PET/CT 可用于评估患者的一般情况，并可根据 FDG 摄取最高的情况帮助选择淋巴结进行切除活检。然而，KFD 可能会导致局部 FDG 摄取，通过模拟恶性肿瘤来限制 PET/CT 的特异性。因此，PET/CT 的阳性结果应谨慎解读。
