Kikuchi Disease in the Neck: CT and US Appearances

Kim, Chang Soo; Park, Dong Woo; Song, Soon Young; Park, Choong Ki; Lee, Seung Ro; Hahm, Chang Kok

Abstract

PURPOSE
This study was undertaken to evaluate the CT and ultrasonographic characteristics of Kikuchi disease showing cervical lymphadenopathy.
MATERIALS AND METHODS
We evaluated the radiological findings of seven patients with histologically proven kikuchi disease. Two males and five females aged between 14 and 27 years(mean, 24.8)were included. Contrast enhanced CT scan was performed in six patients, and US in two.
RESULTS
Clinical symptoms presented included palpable cervical lymphadenopathy(n=7), fever(n=5) and tenderness(n=6). In five patients, CTshowed upper and middle internal jugular chains and spinal accessory chains, right lower internal jugular chainand right supraclavicular node in one. Five of seven patients had bilateral involvement. On contrast-enhancedCT(n=6), homogeneous lymph node enhancement was seen in three patients with isodense enhancement in two, and hyperdense enhancement in one patients. Another three patients had inhomogeneously enhanced lymph nodes with central low density. Extranodal extension was seen in five. On US(n=3), the nodes were homogeneously isoechoic and smoothly marginated in two patients, and another patient had inhomogeneous lymph nodes with central hypoechogenicity and a thick rim.
CONCLUSION
Clinical and radiological finding in our Kikuchi disease patients were nonspecific, and the diagnosis should be established only after lymph node biopsy. We suggest that Kikuchi disease be should included in the differential diagnosis of conglomerated cervical lymphadenopathy, especially inyoung women.