J Korean Radiol Soc. 2005 Jan;52(1):31-36. Korean.
Published online Jan 31, 2005.
Copyright © 2005 by The Korean Society of Radiology
Original Article

Ultrasonographic Features of BCG Lymphadenitis

Do Youn Kim, Sun Wha Lee and Ji Young Hwang
    • Department of Diagnostic Radiology, College of Medicine, Ewha Womans University, Korea.

Abstract

Purpose

To evaluate the ultrasonographic findings of BCG lymphadenitis complicated by BCG vaccination in children

Materials and Methods

Ultrasonography was performed for 22 cases of BCG lymphadenitis in 21 patients who were diagnosed by clinical (n=10) or pathological (n=11) examinations. Their age ranged from 4 months to 3 years (mean age; 14 months). We retrospectively analyzed the ultrasonographic findings for location, multiplicity, size, shape, margin, echogenecity, posterior enhancement, calcifications, inner anechoic portion and Doppler pattern of the BCG lymphadenitis.

Results

The BCG lymphadenitis was found at the axillary area in 15 cases (68%) and at the supraclavicular area in 7 cases (32%). There were ten cases (45%) of solitary lesion and 12 cases (55%) of multiple conglomerated lesions. The maximum diameter ranged from about 0.9 cm to 3.2 cm. The BCG lymphadenitis showed as round (82%), well defined (86%), or heterogeneous hypoechoic (68%) lesions with posterior enhancement (78%). Calcifications were found in 6 cases (27%) and 5 cases (83%) had been vaccinated more than 5 months ago. There were eccentric inner anechoic portions in 16 cases (73%), which were pathologically confirmed as having caseating necrosis. There were increased Doppler flow patterns in 15 cases (68%); 4 cases (18%) were of the central type, 6 cases (27%) were of the peripheral type and 5 cases (23%) were of mixed type.

Conclusion

BCG lymphadenitis is frequently located at the axillary area adjacent to a vaccination site. The ultrasonographic findings of BCG lymphadenitis are well-defined, round, heterogeneously hypoechoic lesions with posterior enhancement, calcifications and inner eccentric anechoic portion.

Keywords
Bacillus Calmette-Guerin (BCG); Children; Lymphatic system; Ultrasound (US)


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