Clinical and Radiologic Characteristics of Kikuchi's Disease

Chung, Phil Sang; Lee, Sang Joon; Yoon, Jun Sik; Park, Se Jin; Kim, Ji Sun; Moon, Jeong Hwan

Abstract

BACKGROUND AND OBJECTIVES: Kikuchi's disease (histiocytic necrotizing lymphadenitis) is a rare self-limiting disorder that typically affects the cervical lymph nodes. It has been occasionally misdiagnosed as tuberculous lymphadenitis or malignant lymphoma. In this study, we analyzed the clinical and radiologic characteristics and tried to find the differential points of Kikuchi's disease.
SUBJECTS AND METHOD
Fifty-two patients who underwent, from January 1998 to December 2004, a excisional biopsy or fine needle aspiration of a cervical lymph node and diagnosed histologically with Kikuchi's disease were enrolled in this study. We retrospectively reviewed the medical record and imaging of each patient. The patients were followed up for a period of 14 to 200 seven days.
RESULTS
Patients were 36 women and 16 men (2.3:1) with the mean age of 23.7 years old. The affected cervical lymph nodes were most commonly located in the posterior cervical triangle (Level V, 83%). Multiple and unilateral cervical lymph nodes were affected in 23 and 16 patients, respectively. The dimensions of affected lymph nodes were in the range of 1 to 2.5 cm (mean 1.73 cm). Leukopenia was observed in 21 patients (46%) fever in 24 patients (46%). CT finding of Kikuchi's disease appeared to be similar to tuberculous lymphadenitis but it had more homogenous density. One patient was recurred after 104 days since she was diagnosed as Kikuch's disease by biopsy.
CONCLUSION
The difinite diagnosis of Kikuch's disease was determined by pathology. But half of the patients show clinical and radiologic features suggestive of Kikuch's disease. Short term use of steroid with high index of suspicion will reduce the unnecessary open biopsy in patient with Kikuchi's disease.