Журнал молекулярной визуализации и динамики
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The Role of PET/CT in the Diagnosis of Kikuchi-Fujimoto Disease: A Case Series and Review of the Literature

Fabian P Mghanga*, Khamis H Bakari and Henry A Mayala

Introduction: Kikuchi-Fujimoto disease (KFD), also known as Kikuchi’s disease or histiocytic necrotizing lymphadenitis, is a self-limiting case of non-cancerous lymphadenopathy. Although previous reports have demonstrated its physical findings and traditional imaging characteristics, few studies mentioned the application of 18fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET/CT) imaging in the diagnosis and follow-up of this disease. Here, we present three cases of KFD, describe the findings from PET/CT images and review the relevant literature to improve the diagnosis of this rare disease.

Case presentation: Three patients, two females (15 and 16 years old) and one male (28 years old), with KFD were diagnosed by biopsy. All patients presented with bilateral cervical lymph nodes and no history of fever, and underwent multiple physical examinations, conventional imaging (Ultrasonography, CT and MRI) and 18F-FDG PET/CT. The images from 18F-FDG PET/CT revealed increased FDG uptake in all three patients. We also observed that the maximum standardized uptake value (SUVmax) in the affected lymph nodes in our patients ranged from 4.85 to 21.1 (mean ± SD, 10.53 ± 3.02) and the mean of SUVmax values ranged from 3.5 to 17.3 (mean ± SD, 7.35 ± 4.13), while 12 out of 16 large nodes with the maximum values of SUVmax were located in the cervical region. All patients presented with splenomegal which showed low affinity to FDG.

Conclusion: Our study showed that 18F-FDG PET/CT imaging of KFD was mainly characterized by mild-tomoderate FDG uptake on the affected lymph nodes with maximum diameter of less than 35 cm and no or mild lymph node fusion and rarely extra-nodal infiltration. Moreover, 18F-FDG PET/CT may be a useful tool in the diagnosis of KFD prior to biopsy; where location, size and the response to FDG may be the important and useful factors for making clinical decision for biopsy.