Kikuchi-Fujimoto Disease Masquerading as Dysphagia with an Isolated Pulmonary Nodule: A Clinical Conundrum

INTRODUCTIONKikuchi-Fujimoto Disease (KFD), also known as Histiocytic Nectrotizing Lymphadenitis is a rare disease, more commonly seen in young Asian women. Though the exact cause is unknown but several Autoimmune and Infectious etiologies have been postulated. It is characterized by cervical lymphadenopathy, low-grade fever, night sweats and leucopenia. It clinically mimics several diseases, leading to misdiagnosis and inappropriate treatment. Diagnosis is confirmed by Histopathological Examination of the Lymph node.CASE REPORTA 40 year old Male with no comorbidities, presented with complaints of multiple Neck swellings, Dysphagia and odynophagia for both solids and liquids for 2 months, associated with low-grade fever and significant weight loss. On examination, multiple bilateral cervical lymph nodes were palpable. Hematological study showed raised ESR (Erythrocyte Sedimentation Rate) and CRP (C-Reactive Protein). Ultrasonography and Contrast-Enhanced CT (CECT) Neck showed multiple bilateral Cervical and Preauricular lymphadenopathy . CECT Chest revealed Hilar and Mediastinal lymphadenopathy with calcifications and a solitary pleural-based solid pulmonary nodule in the anterior segment of the lower lobe of the right lung. Excision biopsy and Histopathology confirmed the diagnosis of Kikuchi-Fujimoto disease. The patient completely recovered with a short course of oral Methylprednisolone (tapering dose) and antibiotics.CONCLUSIONAtypical presentations of Kikuchi-Fujimoto disease pose a diagnostic challenge and may lead to inappropriate treatment and complications. It should be considered in patients presenting with persistent low-grade fever, cervical lymphadenopathy and leukopenia. A multidisciplinary approach is crucial for timely and accurate diagnosis. Greater clinical awareness of this rare entity is essential to prevent misdiagnosis and inappropriate management.