Published in:
01-11-2014 | Original Article
Diagnostic accuracy of the clinical and CT findings for differentiating Kikuchi’s disease and tuberculous lymphadenitis presenting with cervical lymphadenopathy
Published in: Japanese Journal of Radiology | Issue 11/2014
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Purpose
To determine the optimal clinical and CT findings for differentiating Kikuchi’s disease (KD) and tuberculous lymphadenitis (TB) in patients presenting with cervical lymphadenopathy.
Materials and methods
From 2006 to 2010, 87 consecutive patients who were finally diagnosed with KD or TB were enrolled. Two radiologists performed independent analysis of contrast-enhanced neck CT images with regard to the involvement pattern, nodal or perinodal changes, and evidence of the previous infection. Significant clinical and CT findings of KD were determined by statistical analyses.
Results
Of the 87 patients, 27 (31 %) were classified as having KD and 60 (69 %) as having TB. Statistically significant findings of KD patients were younger age, presence of fever, involvement of ≥5 nodal levels or the bilateral neck, no or minimal nodal necrosis, marked perinodal infiltration, and no evidence of upper lung lesion or mediastinal lymphadenopathy. The presence of four or more statistically significant clinical and CT findings of KD had the largest area under the receiver-operating characteristic curve (A
z = 0.861; 95 % confidence intervals 0.801, 0.909), with a sensitivity of 89 % and specificity of 83 %.
Conclusion
CT can be a helpful tool for differentiating KD from TB, especially when it is combined with the clinical findings.