A 22-year-old male presented with painful lymphadenopathy in the left laterocervical region for 4 months, which did not decrease in size with antibiotics or NSAI.
The patient reported several days of fever of up to 38 oC and night sweats due to constipation, coughing and pharyngeal discomfort, symptoms that disappeared.
On examination, the patient had an adenopathy in the left laterocervical region of 2 cm in diameter, not adhered to superficial or deep planes, not painful to palpation and elastic consistency.
He also had two other adenopathies with similar characteristics, approximately 1.5 cm in diameter, in the left supraclavicular region and right laterocervical region.
The rest of the examination showed no relevant findings.
Complete blood count, biochemistry with tumor markers (CEA, α FP, PSA), chest X-ray, abdominal ultrasound and immunological study (ANAs, ANTI-RNP, ANTI-ROMmB, NRTI-
Mantoux was negative.
Serology was performed with the following results: toxoplasmosis, brucellosis, CMV, EBV, HIV, syphilis, adenovirus, mycoplasma, HBV Paper, HCV, Salmonella typhi and paratyphicci IgM negative for rubI, IgM + weak
Biopsy of the left laterocervical adenopathy was performed, with the following result: lymph node showing its preserved architecture, except in an area that affects the cortical and paracortical areas in which there is an abundant lymphoid proliferation Tblasts.
No granulocytes were observed.
The rest of the ganglion shows follicles with activated germinal centers and paracortical zone stimulation.
This biopsy was diagnostic of histiocytic necrotizing lymphadenitis or Kikuchi-Fujimoto disease.
