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

Ji Soo Seol; Young Eun Ha; Su Hyeon Yoo; Ki Bae Bang; Eun Hye Park; Su Young Jung; Jung-Soo Pyo; Seung Wan Chae; Joon-Sup Yeom

doi:10.3947/ic.2012.44.6.535

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Seol, Ha, Yoo, Bang, Park, Jung, Pyo, Chae, and Yeom: A Case of Intra-Abdominal Kikuchi's Disease with Increased FDG Uptake on PET-CT that Mimicked Intra-Abdominal Lymphoma

Case Report

Infection & Chemotherapy

Infection & Chemotherapy 2012; 44(6): 535-539.

Published online: 31 December 2012

DOI: https://doi.org/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

Ji Soo Seol¹, Young Eun Ha¹, Su Hyeon Yoo¹, Ki Bae Bang¹, Eun Hye Park¹, Su Young Jung², Jung-Soo Pyo³, Seung Wan Chae³, Joon-Sup Yeom¹

¹Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyukwan University school of Medicine, Seoul, Korea.

²Department of Nuclear Medicine, Kangbuk Samsung Hospital, Sungkyukwan University school of Medicine, Seoul, Korea.

³Department of Pathology, Kangbuk Samsung Hospital, Sungkyukwan University school of Medicine, Seoul, Korea.

Correspondence to Joon-Sup Yeom, M.D., Ph.D. Department of Internal Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, 108 Pyeong-dong, Jongno-gu, Seoul 110-746, Korea. Tel: +82-2-2001-2472, Fax: +82-2-2001-1596, joonsup.yeom@gamil.com

Received 19 July 2012 Revised 12 September 2012 Accepted 19 September 2012

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Intra-abdominal lymphadenopathy, Kukuchi's disease, Positron-emission tomography

Figures and Tables

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.

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).

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).

Table 1

Reported Cases of Intra-abdominal Kikuchi's Disease in the Literature

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