The fine-needle aspiration cytology and clinical findings of Kikuchi–Fujimoto disease in pediatric patients: a retrospective clinical study

Abstract

Background

Histological evaluation of lymph node is crucial for the definitive diagnosis of Kikuchi–Fujimoto disease (KFD). However, lymph node biopsy under local anesthesia is often difficult in pediatric patients.

Objectives

We evaluated cytological findings for pediatric patients with prolonged cervical lymphadenitis clinically suggestive of KFD and investigated the clinical characteristics of patients diagnosed with KFD by fine-needle aspiration cytology (FNAC).

Methods

This retrospective clinical study included 58 Japanese pediatric patients with cervical lymphadenitis who underwent FNAC.

Results

Cytological diagnosis was KFD for 22 and suspicion of KFD for 11 patients. The remaining 25 patients were diagnosed with non-specific lymphadenitis (NSL). Tenderness was independently associated with a higher frequency of both KFD in narrow and broad senses, compared with NSL (p = .009; p = .038). The percentage of patients who underwent FNAC within 28 days from symptom onset tended to be higher among patients with KFD in a narrow sense than those with NSL (p = .052).

Conclusion

This study indicated that the period from symptom onset to FNAC (<28 days) and the symptom of tenderness were associated with the cytological diagnosis of KFD.

Chinese abstract

背景：淋巴结的组织学评估对于明确诊断菊池-藤本病 (KFD) 至关重要。然而, 对于儿科患者, 局部麻醉下进行淋巴结活检通常很困难。

目的：我们评估了临床提示 KFD 的长期颈部淋巴结炎儿童患者的细胞学检查结果, 并调查了通过细针抽吸细胞学法 (FNAC) 诊断为 KFD 的患者的临床特征。

方法：这项回顾性临床研究包括 58 名接受 FNAC 的颈淋巴结炎日本儿童患者。

结果：细胞学诊断为 KFD的有 22 例, 怀疑为 KFD的有 11 例。其余 25 名患者被诊断为非特异性淋巴结炎 (NSL)。与 NSL 相比, 压痛症状与狭义KFD和广义 KFD 的较高频率独立相关（p = .009；p = .038）。狭义KFD 患者在症状出现后 28 天内接受 FNAC 的百分比往往高于 NSL 患者（p = .052）。

结论：本研究表明, 从症状出现到 FNAC 的时间（<28 天）和压痛症状都与 KFD 的细胞学诊断有关。

Keywords:

• Kikuchi–Fujimoto disease
• pediatric lymphadenitis
• fine-needle aspiration cytology

Disclosure statement

The authors report no financial interests, relationships, and affiliations relevant to the subject of the manuscript.