Kikuchi-Fujimoto Disease Masquerading as a Parotid Tumor-Case Report

以腮腺腫瘤為表徵的菊池－藤本氏病－病例報告

陳建志(Jiann-Jy Chen) ； 林曜祥(Yaoh-Shiang Lin) ； 陳拓安(Tuo-An Chen)

《慈濟醫學雜誌》 18卷6期 (2006/12) Pp. 442-444

https://doi.org/10.6440/TZUCMJ.200612.0442

摘要

菊池－藤本氏病(Kikuchi-Fujimoto disease)，又名組織球性壞死性淋巴結炎(histiocytic necrotizing lymphadenitis)，好發於年輕女性，臨床上常以頸部腫塊伴隨不明熱為表徵。本病例為－48歲男性，因突發性右側腮腺腫塊1個多月，求診時腫塊已達3×3cm，經超音波導引細針穿刺細胞學檢查為良性的淋巴樣細胞，但因腫塊快速增大，無法完全排除惡性的可能，因此接受腮腺淺葉切除術。術中發現緊鄰腮腺淺葉被膜有一堅實、大小3×3cm的腫瘤，冰凍切片及永久切片報告均為組織球性壞死性淋巴結炎。經此案例可知，菊池－藤本氏病可以單一、快速增大，發生在中年男性且以疑似腮腺腫瘤為表徵，實際上是鄰近腮腺的組織發生了組織球性壞死性淋巴結炎，故臨床上耳下附近的疑似腮腺腫瘤病灶，應將本病列入鑑別診斷。超音波導引細針穿刺細胞學檢查可以協助診斷，進一步診斷有待術後病理結果以確立診斷。本病的預後良好，就算不經治療，也可在幾個月內自行痊癒。

關鍵字

組織球性壞死性淋巴結炎 ； 菊池－藤本氏病 ； 腮腺腫瘤

並列摘要

Kikuchi-Fujimoto disease is also called histiocytic necrotizing lymphadenitis, and it presents as neck masses accompanied by a fever of unknown origin. There is a young female predominance. A 48-year-old man presented with a sudden, swelling, 3×3cm mass in the right parotid region for at least a month. Sonographically guided fine-needle aspiration cytology revealed benign lymphoid cells. The mass grew so rapidly that malignancy was highly suspected clinically, so a superficial parotidectomy was performed. A firm tumor was identified adjoining the capsule of the superficial lobe of the parotid gland. Both frozen section and pathologic reports showed histiocytic necrotizing lymphadenitis. In conclusion, Kikuchi-Fujimoto disease can masquerade as a single, rapidlygrowing, parotid tumor in a middle-aged man. Because it is histiocytic necrotizing lymphadenitis adjoining the parotid gland, Kikuchi-Fujimoto disease should be considered a cause of parotid tumor. An impression can be made via sonographically guided fine-needle aspiration cytology, and a final diagnosis should be made via pathology studies following surgery. This disease has a good prognosis and will remit in several months without treatment.

並列關鍵字

histiocytic necrotizing lymphadenitis ； Kikuchi-Fujimoto disease ； parotid tumor