kikuchi disease radiology

The enhancement pattern in this patient is categorized as group 1. https://doi.org/10.1371/journal.pone.0181169.g001. Semin Diagn Pathol. This suggests that in necrotic lymphadenopathy, enhancement patterns are significant CT features to distinguish TL from KD and RH. Please confirm that you would like to log out of Medscape. Sporadic cases are seen in other geographic regions, however these are uncommon. 113(6):761-4. Address correspondence to S.-F. Ko ( sfatko@adm.cgmh.org.tw ). Competing interests: The authors have declared that no competing interests exist. [Medline]. Kikuchi's disease and the skin: case report and review of the literature. J Pediatr Hematol Oncol. 27(8):1073-5. 2014 Nov. 93 (24):372-82. Found insideJinzaki M, Kikuchi E, Akita H, Sugiura H, Shinmoto H, Oya M. Role of computed tomography urography in ... Imaging of urethral disease: a pictorial review. A 29-year-old British Pakistani woman presented with a 2-month history of drenching fevers, night sweats, lethargy and tender cervical and axillary lymphadenopathy. 2018:1791627. [Medline]. Diagn Cytopathol. Necrosis of lymph node tissue is caused by apoptosis and may be virally induced. Familial cases of KFD in the literature are rare. No significant differences were observed in the shape (L/S ratio) of the lymph nodes. Histopathology of the involved lymph nodes differentiates Kikuchi disease from several more . hkato . Poulose V, Chiam P, Poh WT. Citation: Shim EJ, Lee KM, Kim EJ, Kim H-G, Jang JH (2017) CT pattern analysis of necrotizing and nonnecrotizing lymph nodes in Kikuchi disease. aracterize the imaging features of Kikuchi disease. Immunohistochemical studies reveal the following: The immunophenotype of Kikuchi disease is primarily composed of mature CD8-positive and CD4-positive T lymphocytes; lymphocytes and histiocytes also exhibit a high rate of apoptosis, Relatively few B cells and natural killer (NK) cells are present, Positive immunostaining results by monoclonal antibody Ki-M1P are seen in Kikuchi disease but not in malignant lymphoma. We recorded the total number, location, and size of the affected cervical lymph nodes, and two radiologists reviewed the characteristic imaging findings, including the presence of necrosis, cortical enhancement pattern, perinodal infiltration, conglomeration and nodal calcification, to form a consensus. We measured at least three regions in the same nodal parenchyma, excluding hilar vessels, and then averaged the values. Supari D, Ananthamurthy A. Kikuchi-fujimoto disease: a study of 24 cases. Only NCA/M (P = .008, adjusted odds ratio 62.76) differentiated KD from RH+TL groups, but no other variables. The enhancement pattern for this patient is classified as group 1. https://doi.org/10.1371/journal.pone.0181169.g006. [Medline]. Kwon SY, Kim TK, Kim YS, et al. [Systemic lupus erythematosus and Kikuchi-Fujimoto disease mimicking tuberculosis] [French]. Kikuchi-Fujimoto disease is characterized by cervical lymphadenopathy occurring in young adults. J Clin Rheumatol. [Medline]. 2018 Jun. https://doi.org/10.1371/journal.pone.0181169.g005. J Laryngol Otol. 144(4):885-9. Given its clinical presentation, there is often initial concern for lymphoma and diagnosis requires lymph node biopsy. To date, only a few reports have suggested an association between HLH and KD. Found inside – Page 49Cyclic Cushing syndrome due to an ectopic pituitary adenoma. ... Fujisawa I, Kikuchi K, Nishimura K, Togashi K, Itoh K, Noma S, et al. Found inside – Page 243Resnick D. Degenerative disease of the spine. ... Radiology 1957; 68:718–720. ... Kikuchi S, McNab I, Moreau P. Localisation of the level of symptomatic ... There were no significant differences between RH and TL (P = .934). Other studies found that KD patients showed no or minimal nodal necrosis and marked perinodal infiltration in contrast to the marked extent of nodal necrosis in TL [4,12]. Kato H, Kanematsu M, Kato Z, Teramoto T, Kondo N, Hirose Y, et al. The main symptoms include swollen lymph nodes in the neck, mild fever, and night sweats. Because of its non-specific clinical features, the disease can be easily mistaken for other forms of lymphadenitis with a high rate of misdiagnosis . : Intracranial transplantation of the omentum for cerebrovascular moyamoya disease. [Medline]. 12 (7):e0181169. 96 (11):e6332. Tong TR, Chan OW, Lee KC. Histiocytic necrotizing lymphadenitis (Kikuchi-Fujimoto's disease) mimicking systemic lupus erythematosus: a review of two cases. [Full Text]. Karen Seiter, MD Professor, Department of Internal Medicine, Division of Oncology/Hematology, New York Medical College Found inside – Page 310Lumbar degenerative disk disease. Radiology. 2007;245:43–61. Cortes DH, Jacobs NT, Delucca JF, Elliott DM. Elastic, permeability and swelling properties of ... The aim of this study was to review the authors' institutional experience with KD in children over a 16-year period. Diseases & Conditions, encoded search term (Kikuchi Disease) and Kikuchi Disease, VEXAS: A Novel Rheumatologic, Hematologic Syndrome That's Making Waves, ALK-positive Anaplastic Large Cell Lymphoma Undiagnosed in a Patient With Tuberculosis, Appropriate Timing for a Biochemical Evaluation After Adrenalectomy for Unilateral Aldosterone-Producing Adenoma. [Medline]. Understanding the typical and atypical imaging characteristics of Castleman's disease is important for the diagnosis of this uncommon disease entity. Found insideThis text unifies this body of knowledge into an educational resource capturing the core competencies required of an emergency radiologist. (A, B) Conglomerated unilateral cervical lymphadenopathies are shown on axial and coronal CT scans, with homogeneous, strong cortical enhancement and mild perinodal infiltration. Received 20 Nov 2013. Yasukawa K, Matsumura T, Sato-Matsumura KC, et al. here. Academic Editor: K. Kawauchi. Wang M, Yu X, Yang Y. 6,7 It is generally a benign disease that resolves spontaneously in 1-4 months, but cases with a poor outcome and atypical presentation have been reported. In addition, the enhancement pattern according to the degree of necrosis discriminated between KD and TL in the case of necrotic lymphadenopathy. [Full Text]. Jung IY, Ann HW, Kim JJ, Lee SJ, Kim J, Seong H, et al. Kikuchi disease usually presents with unilateral cervical lymphadenopathy and the lymph nodes are reported to be smaller in size compared to those in lymphoma and RDD . Pediatrics. Shim EJ, Lee KM, Kim EJ, Kim HG, Jang JH. Cases with abundant CD30-positive cells occurred predominantly in female patients with only mild symptoms and normal laboratory data. 2005 May. A clinicopathologic study of 79 cases with an analysis of histologic subtypes, immunohistology, and DNA ploidy. [Full Text]. Kikuchi-Fujimoto disease associated with systemic lupus erythematosus. [Full Text]. Finally, if abundant foamy histiocytes are present, it is classified as xanthomatous with or without necrosis. 2017. [Full Text]. CT imaging often reveals nodal necrosis and peri-nodal infiltration in Kikuchi disease; these features could aid in differentiating this condition from RDD ( 10 ). Therefore, the purpose of our study was to determine CT features that differentiate KD from TL and RH. Korean J Radiol. Objective. Charles S Kuzma, MD Consulting Staff, Clinical Research Coordinator, First Health of the Carolinas Cancer Center https://profreg.medscape.com/px/getpracticeprofile.do?method=getProfessionalProfile&urlCache=aHR0cDovL2VtZWRpY2luZS5tZWRzY2FwZS5jb20vYXJ0aWNsZS8yMTA3NTItd29ya3Vw, Homogeneous lymph node enlargement (83.3% of patients), Prominent areas of low attenuation suggestive of focal necrosis (16.7%), Absence of necrosis (rarely, presence of partial necrosis), Normal vascular pattern on power Doppler ultrasound (ie, hilar vascular structures are central or branch radially from the hilum in both longitudinal and transverse planes), Incomplete architectural effacement with patent sinuses, Presence of numerous reactive histiocytes. The mean NCA and NCA/M are 116.0 and 1.71, respectively. [Medline]. KFD frequently presents with necrotic lesions and recurrences, which are also features of metastatic LNs. for: Medscape. 1995 Jul. The typical clinical signs are cervical lymphadenopathy, fever, and symptoms of respiratory infection, and less frequently chills, night sweats, arthralgia, rash, and weight loss. Methodology, Am J Clin Pathol. 23 (2):99-102. J Am Acad Dermatol. Results from autoimmune antibody studies, including LE preparation and rheumatoid factor (RF) and antinuclear antibody (ANA) studies, are generally negative; these findings may help the clinician distinguish Kikuchi disease from SLE. [Medline]. However, the radiologic manifestations of uveitis may be applicable to a variety of inflammatory processes and so are important for the radiologist to recognize. MR imaging findings of cervical lymphadenopathy in patients with Kikuchi disease. Yilmaz M, Camci C, Sari I, et al. Medicine (Baltimore). 2020 Jan. [Medline]. Furthermore, we calculated the NCA-to-muscle ratio (NCA/M) using adjacent sternocleidomastoid or trapezius muscles. Hutchinson CB, Wang E. Kikuchi-Fujimoto disease. These results were presented with adjusted odds ratios and 95% confidence intervals. 122(1):141-52. To date, only a few reports have suggested an association between HLH and KD. [Medline]. [Medline]. A Challenging Case of Kikuchi-Fujimoto Disease Associated with Systemic Lupus Erythematosus and Review of the Literature. Arch Pathol Lab Med. 2005 Dec. 11(6):341-2. It is however infrequent in children. [Medline]. In addition, we compared two attenuation indices on the nonnecrotic portion of the affected lymph nodes, nodal cortical attenuation (NCA) and the ratio of NCA to the adjacent muscle (NCA/M). The short diameter of the lymph nodes was significantly shorter in KD than in TL (P = .001). Infect Chemother. Sara J Grethlein, MD, FACP Professor of Clinical Medicine, Indiana University School of Medicine; Medical Director of Cancer Services, Indiana University Health, Adult Academic Health Center, IU Simon Cancer and IU North Hospital, Joe and Shelly Schwarz Cancer Center Radiology Case. This disorder is often mistaken for malignant lymphoma, especially cervical adenopathy because the symptoms are very similar. Kikuchi-Fujimoto disease is a rare, idiopathic and generally self-limiting cause of lymphadenitis of unknow etiology with a low recurrence rate. The patients’ characteristics are summarized in Table 1. 2001 Nov-Dec. 45(6):953-7. [Medline]. Only the mean NCA/M value was a statistically significant CT feature (p = .008) in differentiating KD from both RH+TL. 1988 Nov. 5(4):329-45. Tong TR, Chan OW, Lee KC. Kikuchi's disease (histiocytic necrotizing lymphadenitis). [Medline]. First described independently in 1972 by Kikuchi and Fujimoto et al,1,2 KFD is an Formal analysis, Cytopathology. Found inside – Page 156Radiology 196:211–218 6. Kikuchi M, Asato M, Sugahara S (1996) Evaluation of surgically formed collateral circulation in moyamoya disease with 3D-CT ... (Table 2, Figs 1–6). Cytologic examination by fine needle aspiration (FNA) can suggest the diagnosis of Kikuchi disease, especially when supported by typical clinical findings, but excisional biopsy of an involved lymph node is needed to confirm the diagnosis in doubtful cases. A definitive diagnosis of Kikuchi disease can be made only by tissue evaluation. However, the high cortical CT attenuation combined with an indistinct nodal architecture was a supportive imaging finding in lymph nodes with KD. [Medline]. All patients had affected cervical nodes at level V. Other frequently affect-ed nodes were at levels IV (n=14), II (n=13), III (n=13), and I (n=6); the supraclavicular nodes (n=6) were also affected. [Medline]. Kikuchi-Fujimoto disease is a rare cause of lymphadenopathy and fever of unknown origin in children: report of two cases and review of the literature. Age and enhancement pattern discriminated KD from TL. 2016 Jun. Journal of Radiology Case Reports www.RadiologyCases.com 4 Figure 4: 23 year old male with Kikuchi-Fujimoto disease. Kikuchi disease (KD), which is also referred to as histiocytic necrotizing lymphadenitis or subacute necrotizing lymphadenitis, was first described by Kikuchi and Fujimoto et al. 2001 Apr. In addition, a higher CT attenuation also appeared even in the necrotic portion of KD patients. 2002 Lymphadenopathy or adenopathy is a disease of the lymph nodes, in which they are abnormal in size or consistency.Lymphadenopathy of an inflammatory type (the most common type) is lymphadenitis, producing swollen or enlarged lymph nodes. It has been associated to systemic lupus erythematosus (SLE) either during the course of the disease or as a harbinger . Although 18F-fludeoxyglucose (FDG) uptake on dual-time-point imaging (DTPI) positron emission tomography (PET)/computed tomography (CT) is useful in distinguishing malignant from benign disease, the latter sometimes mimics malignancy on DTPI PET/CT, resulting in a . [Medline]. If a significant difference was determined among the three groups, pairwise comparisons were calculated with the Mann-Whitney U test (P < .017). The sex and age distributions of the patients were analyzed. A clinicopathologic study of 79 cases with an analysis of histologic subtypes, immunohistology, and DNA ploidy. [Medline]. 96 (11):e6332. [31], Characteristic cytologic findings in Kikuchi disease include extracellular debris and intracellular apoptotic debris embedded in the cytoplasm of crescentic and phagocytic macrophages Cytopathology. [Medline]. Is the Subject Area "Lymph nodes" applicable to this article? (LNs) to differentiate between Kikuchi disease (KD) and other common types of infectious lymphadenitis in an East Asian pediatric patient population. Yes Second, since a small ROI was used to measure the nodal cortical attenuation in the affected lymph node avoiding hilar vessels, the possibility of a technical error could not be ruled out. To the best of our knowledge, there has been no study about CT imaging pattern analysis of necrotizing and nonnecrotic lymph nodes in predicting KD. Med Mal Infect. No, Is the Subject Area "Regression analysis" applicable to this article? Am J Emerg Med. 2017 Mar. Postcontrast enhancement may be observed. However, KFD is often misdiagnosed as a malignant disease. Yes Kikuchi-Fujimoto disease (KFD), also known as histiocytic necrotizing lymphadenitis, is a rare cause of lymphadenopathy that most commonly involves the cervical chain. [33] : Shim et al reported that CT imaging pattern analysis of cervical lymph nodes can be used to help differentiate Kikuchi disease from tuberculous lymphadenopathy and reactive hyperplasia. Found insideKuzucu A. Parasitic diseases of the respiratory tract. ... Radiology 1999;210:699–710. Worthy SA, Flint JD, ... Tsujimoto N, Saraya T, Kikuchi K, et al. No, Is the Subject Area "Fats" applicable to this article? Diagnosing Kikuchi's disease on fine needle aspiration biopsy. 2016 Feb 4. Found inside – Page 1931Meyers MA, Charnsangavej C, Oliphant M: Meyers' Dynamic Radiology of the ... Miller WT, Jr, Perez-Jaffe LA: Cross-sectional imaging of Kikuchi disease. Hedia G, Jamel A, Maher A, et al. Found inside... (KERBER and HEILMAN 1985) and the recently introduced Tracker catheter (KIKUCHI et al. ... Disease. One of the very first applications of interventional ... Patient age and sex, lymph node size, location (unilateral or bilateral), necrosis, perinodal infiltration, conglomeration, nodal calcification and enhancement patterns (1/2/3/4) were compared between the three groups (KD, RH, and TL) using the Kruskal-Wallis test. Shipra Kaicker 1, Perry S. Gerard 2,3, Sonal Kalburgi 2, Matthew D. Geller 2 & Dulan Hailoo 2 Pediatric Radiology volume 38, pages 596-597 (2008)Cite this article Autoimmune Manifestations of Kikuchi Disease. Supervision, 2020 Jan. 31 (1):22-25. Found inside – Page 309MRI marrow observations in thalassemia: The effects of primary disease, ... Kato M, Koh K, Kikuchi A, Toyama D, Mochizuki S, Uchisaka N, et al. Yes Sierra ML, Vegas E, Blanco-González JE, et al. Jang YJ, Park KH, Seok HJ. Kikuchi disease, also called histiocytic necrotizing lymphadenitis or Kikuchi-Fujimoto disease, is a disease that affects the lymph nodes, causing lymph node inflammation.The exact cause of the disease is not yet known, although some researchers have suggested it is an infection or autoimmune disorder. 2017 Jun. Kikuchi's disease is an idiopathic illness characterized by a self-limiting lymphadenitis that normally resolves over subsequent weeks or months without specific treatment . World J Clin Cases. [Medline]. Early studies reported that KD frequently affects Southeast Asian females below the age of 30 [2,4]. CT pattern analysis of necrotizing and nonnecrotizing lymph nodes in Kikuchi disease. A two-year follow-up study. Supari D, Ananthamurthy A. Kikuchi-fujimoto disease: a study of 24 cases. Hirayama disease: MR diagnosis. Studies Sexual and reproductive health and rights, Youth empowerment, and Life course. [Medline]. 2008 May 10. epub ahead of print. Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug ReferenceDisclosure: Received salary from Medscape for employment. No, Is the Subject Area "Computed axial tomography" applicable to this article? Mild and homogeneous cortical enhancement is noted. 1999 Sep. 23(9):1040-7. Funding acquisition, 2011 Dec 15. [Full Text]. Presentation with bilateral uveitis is even more rare. Furthermore, Lee et al. High resolution coronal STIR (2650/63) (A) and T1 post contrast (416/13) with fat Perinodal infiltration can be described to consist of four histopathologic stages in active TL and a progression beyond stage 3 indicates periadenitis. [Medline]. Kikuchi disease most frequently manifests as a relatively acute onset of cervical adenopathy associated with fever and a flu-like prodrome. Yes Kikuchi-Fujimoto disease, known as histiocytic necrotizing lymphadenitis, is a benign, self-limiting and systemic disorder involving lymph nodes with unknown aetiology. 2000 Sep. 114(9):709-11. Out of the total 90 patients included in the analysis, there were 20 with cytohistologically confirmed KD (6 men, 14 women; mean age, 27.80 years), 36 with RH (10 men, 26 women; mean age, 33.08 years) and 34 with TL (17 men, 17 women; mean age, 39.82 years). The high-resolution 128-CT (Ingenuity Core 128, Philips Healthcare), 64-CT (Brilliance 64, Philips Healthcare), or 16-CT (LightSpeed 16, GE Healthcare) scanners were employed and 95 ml of nonionic contrast medium (iomeron ® [iomeprol], Bracco, Milan, Italy) power injected intravenously at 2.4 ml/sec into the antecubital vein. 1 A number of recent publications . For more information about PLOS Subject Areas, click Imaging modalities are not helpful in establishing . The fine needle aspiration appearances of Kikuchi's lymphadenitis. Ryoo I, Suh S, Lee YH, Seo HS, Seol HY. : 2 Department of Radiology, Ansan Hospital, Korea University College of Medicine . [Medline]. If you log out, you will be required to enter your username and password the next time you visit. However, our study showed that only the mean short diameter of the lymph nodes was significantly shorter in KD than in TL (P = .001) and no differences were observed in the shape (L/S ratio) of the lymph nodes.
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