Kikuchi-Fujimoto disease misdiagnosed as tubercular lymphadenitis: A puzzle in cervical lymph nodes

Kikuchi-Fujimoto disease (KFD) is a rare and benign condition characterized by regional necrotizing lymphadenopathy. Acute or subacute painful cervical lymphadenopathy is the most common clinical presentation. The characteristic morphology in histopathologic examination of the lymph node specimen is diagnostic of KFD. Fine needle aspiration cytology (FNAC), often employed as the initial diagnostic method, gives inconclusive results due to inadequate specimens. Our patient was a 36-year-old woman who presented with cervical lymphadenopathy for six weeks. Despite an inconclusive FNAC result, she was treated with empirical antituberculosis therapy (ATT). Later, she was diagnosed with KFD in our facility on excisional lung biopsy in view of non-improvement with ATT. Ambiguous cytological findings may usually lead to the initiation of empirical ATT since tuberculosis (TB) is a major cause of cervical lymphadenitis, particularly in TB-endemic areas. As a result, there is not only a delay in the management of the actual disease, but also a chance of developing adverse reactions to ATT.