许多腺病病例,其鉴别诊断包括广泛的病理(包括一些恶性疾病,如淋巴增生性疾病,例如,淋巴瘤),诉诸初级医疗保健。菊池-藤本病是一种罕见的疾病,良性,以腺病为特征的自限性实体,主要在宫颈区域,这可能与体质症状有关。这种特定的病理在初级保健中非常罕见,经常被忽视。这就是为什么必须提高医学素养并在管理这些病例方面提供支持,我们想通过这个案例演示来强调这一点。该病例报告介绍了一名24岁的女性患者,由于右宫颈区域疼痛肿胀持续了两周,她在家庭健康部门寻求咨询。她否认有近期感染史或宪法症状。疼痛和坚硬的右颌下肿块,直径2厘米,在触诊时被确认。最初需要对宫颈区域的软组织进行分析研究和超声检查。分析,没有相关变化;然而,超声显示右颈后链的低回声神经节形成,从耳后区域到颈部的下部区域,最大的尺寸为19x7mm\“。一个月后重新评估患者,由于腺病的数量增加,并进行了新的超声检查,显示“锁骨上腺病”。之后,她被转介到二级保健(中心医院),进行了淋巴结活检,具有Kikuchi-Fujimoto病的组织学结果。患者在血液肿瘤学会诊中保持随访,无痛性腺病,据她说,焦虑症状加重.目前,病人正在接受对症治疗,伴有腺病稳定和焦虑表现。由于疾病复发或自身免疫过程的发展,这些患者需要长期随访。虽然这是一种排除诊断,必须始终考虑这种疾病,因为它可能会与其他需要积极治疗的严重疾病误认为。关于焦虑症与腺病恶化之间的关系,尽管在文献中没有找到确凿的证据,有一些研究已经确定了炎症和某些抑郁症状恶化之间的联系。
Many cases of adenopathies, whose differential diagnosis includes a wide spectrum of pathologies (including some malignant conditions like lymphoproliferative diseases, e.g., lymphomas), resort to primary healthcare. Kikuchi-Fujimoto disease is a rare, benign, self-limiting entity characterized by adenopathies, mainly in the cervical region, which may be associated with constitutional symptoms. This specific pathology is very rare in primary care and is often overlooked. That is why it is essential to promote medical literacy and provide support in managing these cases, which we want to emphasize through this case presentation. This case report presents a 24-year-old female patient who sought a consultation at the Family Health Unit due to a painful swelling in the right cervical region that lasted two weeks. She denied a history of recent infections or constitutional symptoms. A painful and hard right submaxillary mass, measuring 2 cm in diameter, was identified upon palpation. An analytical study and ultrasound of the soft tissues of the cervical region were initially required. Analytically, there were no relevant changes; however, the ultrasound revealed \"hypoechoic ganglion formations in the right laterocervical chains, from the retroauricular region to the lower region of the neck, the largest measuring 19x7mm\". The patient was reassessed one month later, due to an increase in the number of adenopathies, and a new ultrasound was performed that revealed \"supraclavicular adenopathy\". After that, she was referred to Secondary Healthcare (Central Hospital), where a lymph node biopsy was performed, with histological results of Kikuchi-Fujimoto disease. The patient maintains a follow-up in a hemato-oncology consultation, with painless adenopathies that, according to her, get worse with anxiety symptoms. Currently, the patient is being treated symptomatically, with stabilization of adenopathies and anxious manifestations. These patients need long-term follow-up due to the possibility of disease recurrence or the development of autoimmune processes. Although it is a diagnosis of exclusion, this disease must always be considered, since it can be mistaken with other serious pathologies that require aggressive treatments. Regarding the relationship between anxiety disorder and the worsening of adenopathies, although no conclusive evidence was found in the literature, there are some studies that have established a connection between inflammation and the deterioration of certain depressive symptoms.