Comparative Analysis of Tuberculous Lymphadenitis and Kikuchi Disease of the Neck

Abstract

Purpose To compare the clinical and CT manifestations of Kikuchi disease (KD) and tuberculous lymphadenitis (TL).

Materials and Methods 111 patients with TL (55 men, 56 women, mean age 38.6 years, range 13-80 years) and 73 patients with KD (24 men, 49 women, mean age 26.8 years, range 8-61 years) were included in the study. Two observers independently compared sex, age, peripheral white blood cells, erythrocyte sedimentation rate (ESR), nodal distribution, nodal bilaterality, perinodal fat infiltration, muscle abscess, nodal conglomeration, necrotic and non-necrotic lymph nodes in the patients with TL and KD.

Results KD patients showed a female predominance (67.1%). Patients with TL were older. Leukocytopenia and increased ESR were more frequent in patients with KD. KD more commonly affected lymph nodes in level II, III, and V, while TL more commonly involved lymph nodes in the upper paratracheal area. Perinodal fat infiltration was more frequent in KD. Muscle abscess was seen in patients with TL only (14%). Necrotic lymph nodes were more frequent in TL. A thin type was more frequent in TL.

Conclusion KD showed female predominance, leukocytopenia, increased ESR, involvement of levels II, III, and V and frequent perinodal fat infiltration. TL patients were older than KD patients, were commonly affected in the upper paratracheal area, abscesses were shown only in this group and thin type necrotic lymph nodes were more frequent.