Journal List > J Rheum Dis > v.18(3) > 1063917

Bae, Kim, Heo, Seong, Jeong, and Kim: A Case of Kikuchi Disease Accompanied with Bilateral Retinal Vasculitis

Abstract

Kikuchi disease, also called histiocytic necrotizing lymphadenitis, is an uncommon, idiopathic and generally self-lim-ited 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 histo-logic analysis of lymph node, fundoscopy and fluorescein angiography.

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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
jrd-18-220f1.tif
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 ().
jrd-18-220f2.tif
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).
jrd-18-220f3.tif
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