Tumor cells contained surface IgM, kappa type, indicating aī-cell tumor. Penicillin was given for a suspectedĪbscess, but the mass enlarged. Patient 2: A 33-year-old nurse developed a tumor in his left Patient died with disseminated DUNHL on January 15, 1982. In September 1981, another tumor in the spinal cord was Radiation and chemotherapy led to complete A myelogram revealed a T4-T6 block by anĮxtradural mass. A biopsy of an orbital mass and an enlarged cervical Swelling of the right eye and an unsteady gait, and he was Shoulder pain starting in early March 1981. Patient 1: A 28-year-old hospital clerk complained of back and Potential relationship of these cases to the KSOI syndrome, they Because of the rarity of this malignancy and the Non-Hodgkins lymphoma (DUNHL) were diagnosed between March 1981 and Pathogenesis of these disorders among homosexual males in Sanįrancisco was being studied, 4 cases of diffuse, undifferentiated Immunodeficiency syndrome has been described (1,2). Homosexual males and associated with an acquired cellular Pneumonia, and other opportunistic infections (KSOI) involving Lymphoma among Homosexual Males - United StatesĪ recent outbreak of Kaposi's sarcoma, Pneumocystis carinii For assistance, please send e-mail to: Type 508 Accommodation and the title of the report in the subject line of e-mail. Patients with Kikuchi disease have been misdiagnosed as having lymphoma and treated with cytotoxic agents when physicians are unfamiliar with this entity.Persons using assistive technology might not be able to fully access information in this file. This vignette highlights the importance of recognizing Kikuchi disease as a possibility and the necessity of lymph node biopsy. Along with the severity of symptoms seen here, rarer still is KFD in the African-American population. This rather uncommon case of generalized lymphadenopathy, B symptoms, and the pancytopenia even led to a bone marrow biopsy which was negative for malignancy. Treatment is symptom management, and the recurrence rate is low.Ĭonclusions: Constitutional “B symptoms” of fever, night sweats, and weight loss suggest a differential of malignancies, inflammatory disorders and infections. ANA should be performed and lupus needs to be excluded by criteria. Although KFD is found in all racial and ethnic groups, most of the cases are from East Asia and predominantly affects females under the age of 30. Immune response of T-cells and histiocytes to an infectious agent or an autoimmune process is suspected. This showed necrosis and histiocytic infiltrate but no features of malignancy.ĭiscussion: Kikuchi-Fujimoto’s disease (KFD), or histiocytic necrotizing lymphadenitis, tends to be a benign, self-limiting disease of unclear etiology. Certain that the finding would be lymphoma, we obtained an excisional lymph node biopsy. PET scan revealed extensive hypermetabolic lymphadenopathy with splenomegaly and increased splenic uptake. Infectious work-up (influenza, EBV, CMV, toxoplasma, and Bartonella titers, HIV, hepatitis panel, RPR, PPD, urine and blood cultures) as well as ANA and rheumatoid factor were negative. On laboratory evaluation, her complete blood count was consistent with pancytopenia, and transiently reached levels that required neutropenic precautions. Her abdomen was tender over the lower quadrants with mild splenomegaly. Shotty submandibular, submental, axillary, and inguinal lymph nodes were also noted. On exam, she was febrile with visibly bulky cervical lymphadenopathy that was tender to palpation. Case Presentation: A 23-year-old previously healthy African-American female presented with one month history of progressive symptoms: first fever, night sweats, sore throat, malaise and body aches then poor oral intake, severe fatigue, lower abdominal pain and cramping with 10-15 pounds of weight loss and finally intermittent pressure-like chest pain, worsening neck pain, nausea and vomiting.
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