장간막 림프절염으로 발현된 Kikuchi-Fujimoto병 1예
A Case of Kikuchi-Fujimoto Disease Presenting as Mesenteric Lymphadenitis
1
조회
0
다운로드
2
인용
0
참고문헌
초록
Kikuchi-Fujimoto 병은 주로 경부 림프절을 침범하는 질환이지만, 드물게 회맹부 장간막 림프절을 침범하여, 발열을 동반한 우하복부 통증과 반발압통을 나타내는 장간막 림프절염을 일으킬 수 있다. 급성 충수돌기염과 유사한 양상의 급성 복증을 호소하는 젊은 성인의 경우, 장간막 림프절염 여부를 확인하여야하며, 그럴 경우 Kikuchi- Fujimoto 병을 감별 진단에 포함시켜야 한다. 저자 등이 경험한 장간막 림프절염으로 발현된 성인의 Kikuchi- Fujimoto 병 1예는 국내에서는 최초로 발견된 것이기에 문헌 고찰과 함께 보고하는 바이다.
Abstract
Kikuchi-Fujimoto disease or histiocytic necrotizing lymphadenitis is a benign, rare, self limitimg disease presenting with mainly cervical lymphadenopathy and fever unresponsive to antibiotics or medical treatment. A 28-year old man presented with fever and right lower quadrant abdominal pain. Physical examination showed abdominal tenderness and rebound tenderness mimicking acute appendicitis. Imaging studies showed normal appendix and other abdominal organs except enlarged multiple mesenteric lymph nodes. Symptoms persisted despite antimicrobial therapy. Multiple tender lymph nodes were palpable on bilateral cervical area at the 7th hospital day. The biopsy of the neck node showed large areas of patchy, irregular necrosis with prominent nuclear debris surrounded by T lymphocytes, histiocytes without neutrophils and granuloma, so he was diagnosed as Kikuchi- Fujimoto disease. With conservative management, clinical improvement was observed. We suggest that Kikuchi-Fujimoto disease with mesenteric lymphadenitis should be added to the differential diagnosis of acute abdomen mimicking acute appendicitis in young adults.
참고문헌 (16)
- "Lymphadenitis showing focal reticulum cell hyperplasia with nuclear debris and phagocytosis", 35, pp.375~80 (1972)
- "Hemophagocytic Syndrome Associated with Kikuchi's Disease", 18, pp.592~594 (2003)
- "A study of 30 cases Immunohistology and etiology of histocytic necrotizing lymphadenitis Report of three insrtuctive cases", pp.115 829~23 7 39
- "A study of the viral etiology of hitiocytic necrotizing lymphadenitis", 13, pp.27~30 (1998)
- "Perforin and Fas pathways for cytotoxic T-cells in histiocytic necrotizing lymphadenitis", 33, pp.471~476 (1998)
- "Pyrexia of unknown Origin:Kikuchi-Fujimoto disease", 39, pp.138~143 (2004)
- "Management of Kikuchi-Fujimoto's disease using glucocorticoid", 114, pp.709~711 (2000)
- "Kikuchi Fujimoto lymphadenitis:Case report and Literature Review", 74, pp.60~63 (2003)
- "The etiology and clinical chareacteristics of mesenteric adenitis in Korean adults", 12, pp.105~110 (1997)
- "Mesenteric Adenitis:CT diagnosis of primary versus secondary causes,incidence,and clinical significance in pediatric and adult patients", 178, pp.853~855 (2002)
- "Mesenteric histiocytic necrotizing Lymphadenitis.Case report", 42, pp.35~40 (1987)
- "Necrotizing Lymphadenitis presenting as mesenteric lymphadenitis", 40, pp.658~662 (1999)
- "A case of Kikuchi-Fujimoto's disease with abdominal manifestations", 122, pp.962~963 (1997)
- "A cause of Fever of Unknown origin and splenomegaly", pp.99~102 (1988)
- "Necrotizing lymphadenitis Mimicking Acute Appendicitis affecting Mesenteric Lymph node", 6, pp.68~72 (2003)
- "Necrotizing lymphadenitis Mimicking Acute Appendicitis affecting Mesenteric Lymph node", 6, pp.68~72 (2003)