Generalized Lymphadenopathy in a Young Boy: A Rare Presentation of Kikuchi-Fujimoto Disease

Kikuchi-Fujimoto disease (KFD), or histiocytic necrotizing lymphadenitis, is a rare, benign, and self-limiting condition that typically affects young women and is uncommon in children or males. We report the case of a 15-year-old boy who presented with generalized lymphadenopathy involving cervical, axillary, submandibular, and inguinal nodes, along with mild fever and pain. A series of fine-needle aspiration cytology and lymph node biopsies over 3 years initially showed reactive and acute lymphadenitis. The diagnosis of Kikuchi's disease was eventually confirmed on histopathology of an axillary lymph node, which revealed necrotizing lymphadenitis without granulomas. The patient improved with symptomatic treatment using nonsteroidal anti-inflammatory drugs and antibiotics. This case highlights the diagnostic challenges of KFD in an atypical demographic and underlines the importance of repeated histopathological assessment in persistent or recurrent lymphadenopathy.