Shotty lymph nodes on palpation2/18/2024 ![]() Although KFD is found in all racial and ethnic groups, most of the cases are from East Asia and predominantly affects females under the age of 30. Immune response of T-cells and histiocytes to an infectious agent or an autoimmune process is suspected. This showed necrosis and histiocytic infiltrate but no features of malignancy.ĭiscussion: Kikuchi-Fujimoto’s disease (KFD), or histiocytic necrotizing lymphadenitis, tends to be a benign, self-limiting disease of unclear etiology. Certain that the finding would be lymphoma, we obtained an excisional lymph node biopsy. PET scan revealed extensive hypermetabolic lymphadenopathy with splenomegaly and increased splenic uptake. Infectious work-up (influenza, EBV, CMV, toxoplasma, and Bartonella titers, HIV, hepatitis panel, RPR, PPD, urine and blood cultures) as well as ANA and rheumatoid factor were negative. On laboratory evaluation, her complete blood count was consistent with pancytopenia, and transiently reached levels that required neutropenic precautions. Her abdomen was tender over the lower quadrants with mild splenomegaly. Shotty submandibular, submental, axillary, and inguinal lymph nodes were also noted. On exam, she was febrile with visibly bulky cervical lymphadenopathy that was tender to palpation. ICD-10-CM R59.9 is grouped within Diagnostic Related Group(s) (MS-DRG v41.Case Presentation: A 23-year-old previously healthy African-American female presented with one month history of progressive symptoms: first fever, night sweats, sore throat, malaise and body aches then poor oral intake, severe fatigue, lower abdominal pain and cramping with 10-15 pounds of weight loss and finally intermittent pressure-like chest pain, worsening neck pain, nausea and vomiting. Lymphadenopathy: the abnormal enlargement of lymph nodes.Disease or swelling of the lymph nodes.Causes include viral and bacterial infections and cancers that affect the lymph nodes. A clinical finding indicating that a lymph node is enlarged.mesenteric (acute) (chronic) lymphadenitis ( I88.0).(f) certain symptoms, for which supplementary information is provided, that represent important problems in medical care in their own right.(e) cases in which a more precise diagnosis was not available for any other reason.(d) cases referred elsewhere for investigation or treatment before the diagnosis was made.(c) provisional diagnosis in a patient who failed to return for further investigation or care. ![]() (b) signs or symptoms existing at the time of initial encounter that proved to be transient and whose causes could not be determined.(a) cases for which no more specific diagnosis can be made even after all the facts bearing on the case have been investigated.The conditions and signs or symptoms included in categories R00- R94 consist of:.8, are generally provided for other relevant symptoms that cannot be allocated elsewhere in the classification. The Alphabetical Index should be consulted to determine which symptoms and signs are to be allocated here and which to other chapters. ![]() Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'. In general, categories in this chapter include the less well-defined conditions and symptoms that, without the necessary study of the case to establish a final diagnosis, point perhaps equally to two or more diseases or to two or more systems of the body. Signs and symptoms that point rather definitely to a given diagnosis have been assigned to a category in other chapters of the classification. ![]()
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