PMC6081987_01
Computed tomography (CT) scan coronal view head with contrast.. Bilateral lacrimal glands appear large with mild increased enhancement.
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Computed tomography (CT) scan sagittal view neck with contrast.. Bilateral left greater than right cervical jugular chain, level I, occipital and supraclavicular lymph nodes demonstrate heterogeneous enhancement and enlargement, largest demonstrating conglomeration and cystic changes along the left jugular chain measuring up to 8.5 cm in length of the conglomerate.
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Histopathology of cervical lymph node.. Geographical necrosis with fibrinoid deposits and nuclear fragments with apoptotic cells. Surrounding this area are pale histiocytes and lymphocytes. Neutrophils and eosinophils are characteristically absent.
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Epstein Barr virus (EBV) and cytomegalovirus (CMV), bone marrow biopsy and flow cytometry were all negative. Excisional biopsy of the left cervical lymph node revealed characteristic findings of Kikuchi-Fujimoto disease which showed geographic necrosis with fibrinoid deposits and apoptotic cells surrounded by a mononuclear infiltrate characteristically without neutrophils and eosinophils [ Figure 3].