Internal Medicine, EOC, Bellinzona, Switzerland.
Cantonal Institute of Pathology, EOC, Bellinzona, Switzerland.
BMJ Case Rep. 2022 Feb 24;15(2):e244732. doi: 10.1136/bcr-2021-244732.
A 34-year-old man presented to our hospital with a 5-day history of progressive abdominal pain and fever. A CT scan identified extensive mesenteric lymphadenopathy. Initial diagnostic tests were inconclusive. Abdominal lymph node biopsy showed histiocytic necrotising lymphadenitis, compatible with Kikuchi-Fujimoto disease (KFD). This benign and self-limiting disease generally resolves following supportive treatment. In this case, remission occurred within 3 weeks of initial presentation. KFD is a very uncommon cause of lymphadenopathy, and selective mesenteric involvement is rare. Definitive diagnosis often requires lymph node biopsy. It is important to exclude more common and serious differential diagnoses associated with mesenteric lymphadenopathy, while maintaining a minimally invasive diagnostic approach, before progressing to nodal biopsy.
一位 34 岁男性因进行性腹痛和发热 5 天到我院就诊。CT 扫描发现广泛肠系膜淋巴结病。初始诊断性检查结果不明确。腹部淋巴结活检显示组织细胞坏死性淋巴结炎,符合菊池-藤本病(KFD)。这种良性和自限性疾病通常在支持治疗后缓解。在本例中,初始表现后 3 周内即缓解。KFD 是一种非常罕见的淋巴结病病因,选择性肠系膜受累也很少见。明确诊断通常需要淋巴结活检。在进行淋巴结活检之前,重要的是在排除与肠系膜淋巴结病相关的更常见和更严重的鉴别诊断的同时,保持微创诊断方法。