Histiocytic necrotizing lymphadenitis is rare outside Japan, including Brazil, despite the many Japanese immigrants and descendants who live there. The authors describe the case of a 32 year old white female, who presented with cervical lymph node enlargement and severe anemia. Histological findings of the lymph node were typical for Kikuchi's disease. Bone marrow showed hyperplasia of normoblasts, suggesting hemolysis, but a Coombs' test was negative. The patient had a spontaneous resolution of all symptoms and has remained asymptomatic for 3 years. Especially where this disease is rarely reported, it is important to recognize it, in order to avoid a misdiagnosis of malignant lymphoma.