Infect Chemother.  2012 Dec;44(6):535-539. 10.3947/ic.2012.44.6.535.

A Case of Intra-Abdominal Kikuchi's Disease with Increased FDG Uptake on PET-CT that Mimicked Intra-Abdominal Lymphoma

• Seol JS
• Ha YE
• Yoo SH
• Bang KB
• Park EH
• Jung SY
• Pyo JS
• Chae SW
• Yeom JS

• KMID: 1806950
• DOI: http://doi.org/10.3947/ic.2012.44.6.535

Abstract

Kikuchi's disease is a benign disease characterized mainly by fever and cervical lymphadenitis. We report a case of Kikuchi's disease that manifested as intra-abdominal lymphadenitis. A 39 year old woman presented with fever that had persisted for one week. Her history and physical examination were unremarkable. The laboratory findings revealed mild leukopenia and increased C-reactive protein. Abdominal CT revealed multiple lymph node enlargements in the mesenteric root and around the ileocecal valve. Positron emission tomography-computed tomography (PET-CT) revealed increased 18-fluoro-deoxyglucose(FDG) uptake in the lymph nodes observed by abdominal CT. A laparoscopic excisional biopsy of the lymph node was performed for a confirmatory diagnosis and the pathology findings were compatible with Kikuchi's disease. Although intra-abdominal Kikuchi's disease is a rare disease, it should be considered in a differential diagnosis of intra-abdominal lymphadenopathy with increased FDG uptake on PET-CT.

Keyword

Intra-abdominal lymphadenopathy; Kukuchi's disease; Positron-emission tomography

MeSH Terms

Biopsy
C-Reactive Protein
Diagnosis, Differential
Electrons
Female
Fever
Histiocytic Necrotizing Lymphadenitis
Humans
Ileocecal Valve
Leukopenia
Lymph Nodes
Lymphadenitis
Lymphatic Diseases
Lymphoma
Physical Examination
Positron-Emission Tomography
Rare Diseases
C-Reactive Protein

Figure

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  Figure 1 Abdominal CT scan shows enlarged (A) mesenteric root lymph nodes and (B) ileocolic lymph nodes. After one month, (C) enlarged mesenteric lymph nodes and (D) ileocolic lymph nodes had disappeared.

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  Figure 2 PET-CT scan shows multiple lymph nodes in the mesenteric root (A) and ileocolic area (B) with 18-fluorodeoxyglucose (FDG) uptake (standardized uptake value, SUV 11.3 and 6.8).

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  Figure 3 Pathology of an excisional biopsy of lymph node. (A) Lymph node biopsy shows extensive necrosis of the nodal architecture (H&E, ×100). (B) Positive staining for CD68 in histiocytes (CD68, ×200).

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