Ultrasonographic Evaluation of Kikuchi Disease in the Neck.

Pyeun,  Yong Seon; Lee,  Sang Wook; Rho,  Myung Ho

Journal of Korean Society of Medical Ultrasound 2001;20(3): 221-226.

Yong Seon Pyeun, Sang Wook Lee, Myung Ho Rho

Department of Radiology, Masan Samsung Hospital, Sungkyunkwan University, School of Medicine, Korea.

Published online: September 1, 2001.

ABSTRACT

PURPOSE: To analyze the gray-scale and color doppler US findings of Kikuchi disease showing cervical lymphadenopathy. MATERIALS AND METHODS: We retrospectively reviewed sonograms of cervical enlarged lymph nodes in twenty patients of Kikuchi disease histologically confirmed by US-guided cutting-needle biopsy. We analyzed location, size, shape, and echogenecity of involved node, sharpness of border, surrounding soft tissue, and presence of e-chogenic nodal hilum, as seen on gray-scale sonograms. On color images, we analyzed the patterns of flow signal in involved nodes and surrounding soft tissue. RESULTS: The spinal accessory chains were involved in all twenty cases, followed by in the order of the internal jugular chains(8/20), submental(6/20), supraclavicular nodes(2/20). Shape of involved nodes were ovoid or tubular, and the L/S ratio(ratio of longest to shortest diameter) was 1.94 +/-0.46. In terms of echogenecity, 10 out of 20 showed isoechoic and 10 were hypoechoic. Outer margin was clearly shown in 19 cases, which refer to 95% and only one case was not clear. Surrounding soft tissue were thickened and echogenic in 15 patients(75%) but the rest of the 5 patients showed as a normal. Echogenic hilum was not seen in 17 patients(85%) but the rest of 3 patients showed echogenic hilum. On the color-doppler US, symmetric or central hilar vascularity was noted in all patients. In 14 patients, some flow signals are noted in peripheral soft tissue. CONCLUSION: The color doppler and gray-scale US findings of Kikuchi disease are similar to those of benign lymphadenitis and differ from those of tuberculous nodes and nodal metastases. We suggest that the possibility of Kikuch disease should be considered in the patient of cervical lymphadenopathy with US findings of benign lymphadenitis, especially young women.

Keywords: Neck, US; Lymphatic system, diseases; Ultrasound(US); Doppler studies