J Korean Radiol Soc. 1999 Nov;41(5):879-884. Korean.
Published online Mar 14, 2016.
Copyright © The Korean Radiological Society
Original Article

CT Findings of Kikuchi Disease: Correlation with Pathologic Findings

Ki Nam Kim, Dong Wook Kim, Hyun Jin Kim, Jung Hoon Park, Chang Soo Kim and Hye Sook Kim
    • Department of Diagnostic Radiology, Maryknoll General Hospital, Pusan, Korea.
    • Department of Anatomical Pathology, Maryknoll General Hospital, Pusan, Korea.

Abstract

PURPOSE: To evaluate by means of retrospective analysis of neck CT scans the CT findings which suggest kikuchi disease. MATERIALS AND METHODS: The authors evaluated the CT findings of seven cases of Kikuchi disease histologically confirmed by excisional biopsy. Four males and three females aged between 12 and 43 (mean; 28) years were included. The authors retrospectively analyzed distribution, bilaterality, the presence of aggregation, the presence of intranodal low density after contrast enhancement, the number, size, shape and location of areas of intranodal low density, and the presence of extracapsular extension in involved nodes, as seen on pre- and post-contrast CT scans. Attempts were then made to correlate the CT with the pathologic findings. RESULTS: The range of conditions affecting patients included palpable(7/7) and tender (6/7) nodes, fever(5/7), night sweat(2/7), leukopenia(2/7), and weight loss(1/7). The internal jugular and spinal accessory chains were involved in all seven cases, followed by the submandibular(6/7), submental(5/7), supraclavicular(1/7) and axillary( 1/7) nodes. The findings observed also included bilateral involvement of the internal jugular chain(6/7), the spinal accessory chain(5/7), and the submandibular(4/6) and supraclavicular nodes(1/1). CT revealed that in all cases, pathologic lymph nodes showed aggregation in one or several nodal groups, namely a mixed homogeneous( mean, 60%) or inhomogeneous(mean, 40%) enhancement pattern; intranodal low densities with the number(1 -7), size(1 -7mm) and shape(oval, round, or elongated) of varying degree and predominantly ( 92%) peripheral location, and extracapsular extension. CONCLUSION: The CT findings which suggest Kikuchi disease in cervical lymphadenopathy were (1) involvement varying from no intranodal low density to prominent intranodal low densities; (2) intranodal low densities, with the number, size and shape of varying degree and predominantly peripheral location, which were correlated with pathologic findings, including variable intranodal areas of necrosis areas in mainly cortical and paracortical regions of nodes.

Keywords
Neck, CT; Lymphatic system, disease; Lymphatic system, CT


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