J Korean Med Sci.  2009 Dec;24(6):1105-1109. 10.3346/jkms.2009.24.6.1105.

Kikuchi's Disease in Children: Clinical Manifestations and Imaging Features

• Han HJ
• Lim GY
• Yeo DM
• Chung NG

• KMID: 1783140
• DOI: http://doi.org/10.3346/jkms.2009.24.6.1105

Abstract

Previously published studies on Kikuchi disease (KD) have frequently addressed the computed tomography (CT) findings in the adult population, however, only a few studies have been reported for the pediatric age group. The purpose of this study is to analyze the clinical characteristics and imaging features of KD in children. Fifteen children (2-14 yr) who had a neck CT and pathology diagnosis of KD were included in this study. Clinical features, including the duration of lymphadenopathy and fever, prognosis, and laboratory values, were evaluated. We analyzed the sites, size, and lymph node pattern as seen on their CT scans. The median duration of fever was 10 days. Fourteen patients experienced improvement in their condition, although four of these patients experienced recurrent episodes of KD. All patients had affected cervical nodes at level V. Perinodal infiltrates were observed in the affected cervical nodes in 14 cases (93%), and non-enhancing necrosis was also noted within the affected cervical nodes in 10 cases (63%). In conclusion, the combination of imaging findings in conjunction with clinical findings of KD may help to determine whether or not to perform pathology analysis and follow-up studies.

Keyword

Lymphatic Diseases; Histiocytic Necrotizing Lymphadenitis; Child

MeSH Terms

Adolescent
Adult
Child
Child, Preschool
Female
Fever
*Histiocytic Necrotizing Lymphadenitis/pathology/radiography
Humans
*Lymph Nodes/pathology/radiography
Male
Neck/anatomy & histology/pathology/radiography
Retrospective Studies
Tomography, X-Ray Computed

Figure

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  Fig. 1 A 12-yr-old boy with fever and cervical lymphadenopathy. Axial CT scans of the neck show multiple, small- and medium-sized lymph nodes in both submandibular regions (levels IA) (arrows) and on the right side of the neck (level V) (arrowheads). Note the ring-shaped nodular necrosis (*) on the right side of the neck as A well as the adjacent perinodal infiltration.

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  Fig. 2 A two-year-old girl with fever and bilateral cervical lymphadenopathy. Axial CT scans show multiple, medium-dimension lymph nodes with uniform enhancement on both sides of the neck at levels II and V. Note the increased attenuation in the adjacent superficial space (arrows).

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  Fig. 3 A 10-yr-old girl with intermittent fever and right cervical lymphadenopathy. (A) CT scan shows multiple, small- and medium-sized lymph nodes on the right side of the neck (arrows) (levels IIB and V). Note the perinodal fat obliteration in the adjacent superficial space (arrowhead). (B) US obtained at the same time show somewhat matted, hypoechoic, nodal masses with irregular perinodal borders, suggestive of perinodal infiltrates. (C) MIP FDG-PET scan image shows multiple areas of FDG uptake in the right cervical, supraclavicular, right para-aortic and peripancreatic regions.

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