Kikuchi-Fujimoto Disease Masquerading as Acute Appendicitis.

Area of Science:

• Pathology
• Immunology
• Gastroenterology

Background:

• Kikuchi-Fujimoto Disease (KFD) is a rare, benign condition characterized by necrotizing lymphadenitis, typically affecting cervical lymph nodes.
• Accurate diagnosis of KFD is essential to differentiate it from more serious conditions like lymphoma, tuberculosis, and autoimmune disorders.
• Unusual presentations of KFD, particularly outside the neck, pose diagnostic challenges.

Observation:

• A 30-year-old female presented with symptoms mimicking acute appendicitis, including abdominal pain, vomiting, and fever.
• Initial investigations, including abdominal sonography, suggested acute appendicitis, leading to an appendectomy and mesenteric lymph node excision.
• Histopathological examination of the mesenteric lymph node revealed KFD, confirmed by immunohistochemistry, while the appendix was normal.

Findings:

• Kikuchi-Fujimoto Disease (KFD) can present atypically in mesenteric lymph nodes, mimicking acute appendicitis.
• Histopathology and immunohistochemistry are crucial for diagnosing KFD in unusual locations.
• The appendix was found to be unremarkable in this case, underscoring the lymph node as the primary site of pathology.

Implications:

• KFD should be considered in the differential diagnosis of acute appendicitis, especially when mesenteric lymphadenopathy is present.
• Increased awareness of KFD's varied presentations can prevent misdiagnosis and unnecessary treatments.
• Early and accurate diagnosis of KFD avoids potentially harmful interventions for conditions it may resemble.