J Rheum Dis.  2011 Sep;18(3):220-223. 10.4078/jrd.2011.18.3.220.

A Case of Kikuchi Disease Accompanied with Bilateral Retinal Vasculitis

• Bae J
• Kim J
• Heo ST
• Seong GM
• Jeong JH
• Kim JH

• KMID: 2223155
• DOI: http://doi.org/10.4078/jrd.2011.18.3.220

Abstract

Kikuchi disease, also called histiocytic necrotizing lymphadenitis, is an uncommon, idiopathic and generally self-limited disease, characterized by cervical lymphadenopathy. It can present systemic symptoms and signs, but ocular involvement is unusual. We report a 35-year-old woman who presented sudden decreased visual acuity and a swollen lymph node on the left side of her neck. On laboratory findings, there were no evidences of infection, autoimmune disease and systemic vasculitis. She was diagnosed with Kikuchi disease and bilateral retinal vasculitis by histologic analysis of lymph node, fundoscopy and fluorescein angiography.

Keyword

Kikuchi disease; Necrotizing lymphadenitis; Retinal vasculitis

MeSH Terms

Adult
Autoimmune Diseases
Female
Fluorescein Angiography
Histiocytic Necrotizing Lymphadenitis
Humans
Lymph Nodes
Lymphatic Diseases
Neck
Retinal Vasculitis
Retinaldehyde
Systemic Vasculitis
Visual Acuity
Retinaldehyde

Figure

• 

  Figure 1. Neck CT: There was a 3.3×1.8 cm sized, partially necrotized cervical lymph node from the inside of the left upper sternocl-eidomastoid (SCM) muscle (arrow). It was the biggest node and several other enlarged, but smaller lymph nodes were also found along the inside of the left SCM muscle

• 

  Figure 2. (A, B) Edema (†), soft exudates (∗) and flame shaped hemorrhage (black arrow) could be found around macula on fundos-copic examination. Also, there were several vascular sheathings (white arrow), the hallmark of retinal vasculitis. (C, D) On fluorescein angio-graphy, there were some vascular leakages (‡).

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  Figure 3. (A) On H & E stain, patches of necrosis (∗) and area of histiocyte proliferation (white arrow) were observed (100×). (B) Histiocytes were positive for CD68 (black arrow, 100× optical resolution).

Reference

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