Distribution of lymphadenopathy in patients with Kikuchi disease

Lung Chiung Chen, Chao Jan Wang, Yu Chuan Chang, Shian Sen Shie, Tzou Yien Lin, Yu Chia Hsieh, Kuan Ying Arthur Huang, Chen Yen Kuo, Cheng Hsun Chiu, Yhu Chering Huang, Chih Jung Chen

Research output: Contribution to journalArticle

Abstract

Background: Cervical lymphadenopathy is among the cardinal manifestations of Kikuchi disease (KD). The incidences and locations of extra-cervical lymph nodes (LNs) involvement in KD have not been comprehensively reported. Methods: From 2003 to 2016, 60 patients with pathologically confirmed KD and with computed tomography and/or whole-body inflammation scans at diagnosis were retrospectively identified. The locations, sizes and characteristics of all affected LNs were analyzed by extensive review of the image studies. The clinical and laboratory parameters were abstracted from medical records and the associations with extra-cervical LNs involvement were identified. Results: Female accounted for 35 (58.3%) patients and the median age of all patients was 21.3 years (ranges, 3–64 years). Of 59 patients with evaluable neck images, 42 (71.2%) and 16 (27.1%) patients presented with unilateral and bilateral nodal involvement, respectively, with the most common locations at level II, III and IV by Som's classification. The largest LNs appeared most commonly in level II. The incidences of extra-cervical lymphadenopathy in abdomen, pelvis, inguina, axilla and mediastinum with available images were respectively 52.9% (9/17), 47.1% (8/17), 41.2% (7/17), 30.6% (11/36) and 14.3% (8/56). When compared to cases with solitary cervical lymphadenopathy, the cases with extra-cervical lymphadenopathy had significantly greater incidences of bilateral cervical lymphadenopathy (P =.0379) and leukopenia (P =.0173). Conclusion: Unilateral cervical lymphadenopathy was the most frequent form of LNs involvement of KD. Extra-cervical lymphadenopathy was not uncommon and was associated with the appearance of bilateral distribution of cervical LNs and leukopenia.

Original languageEnglish
JournalJournal of Microbiology, Immunology and Infection
DOIs
Publication statusAccepted/In press - Jan 1 2019

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Histiocytic Necrotizing Lymphadenitis
Lymph Nodes
Leukopenia
Incidence
Whole Body Imaging
Axilla
Mediastinum
Lymphadenopathy
Pelvis
Abdomen
Medical Records
Neck
Tomography
Inflammation

Keywords

  • Computed tomography
  • Kikuchi disease
  • Lymphadenopathy
  • Nuclear medicine
  • Taiwan

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology and Microbiology(all)
  • Microbiology (medical)
  • Infectious Diseases

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Distribution of lymphadenopathy in patients with Kikuchi disease. / Chen, Lung Chiung; Wang, Chao Jan; Chang, Yu Chuan; Shie, Shian Sen; Lin, Tzou Yien; Hsieh, Yu Chia; Arthur Huang, Kuan Ying; Kuo, Chen Yen; Chiu, Cheng Hsun; Huang, Yhu Chering; Chen, Chih Jung.

In: Journal of Microbiology, Immunology and Infection, 01.01.2019.

Research output: Contribution to journalArticle

Chen, LC, Wang, CJ, Chang, YC, Shie, SS, Lin, TY, Hsieh, YC, Arthur Huang, KY, Kuo, CY, Chiu, CH, Huang, YC & Chen, CJ 2019, 'Distribution of lymphadenopathy in patients with Kikuchi disease', Journal of Microbiology, Immunology and Infection. https://doi.org/10.1016/j.jmii.2019.08.016
Chen, Lung Chiung ; Wang, Chao Jan ; Chang, Yu Chuan ; Shie, Shian Sen ; Lin, Tzou Yien ; Hsieh, Yu Chia ; Arthur Huang, Kuan Ying ; Kuo, Chen Yen ; Chiu, Cheng Hsun ; Huang, Yhu Chering ; Chen, Chih Jung. / Distribution of lymphadenopathy in patients with Kikuchi disease. In: Journal of Microbiology, Immunology and Infection. 2019.
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abstract = "Background: Cervical lymphadenopathy is among the cardinal manifestations of Kikuchi disease (KD). The incidences and locations of extra-cervical lymph nodes (LNs) involvement in KD have not been comprehensively reported. Methods: From 2003 to 2016, 60 patients with pathologically confirmed KD and with computed tomography and/or whole-body inflammation scans at diagnosis were retrospectively identified. The locations, sizes and characteristics of all affected LNs were analyzed by extensive review of the image studies. The clinical and laboratory parameters were abstracted from medical records and the associations with extra-cervical LNs involvement were identified. Results: Female accounted for 35 (58.3{\%}) patients and the median age of all patients was 21.3 years (ranges, 3–64 years). Of 59 patients with evaluable neck images, 42 (71.2{\%}) and 16 (27.1{\%}) patients presented with unilateral and bilateral nodal involvement, respectively, with the most common locations at level II, III and IV by Som's classification. The largest LNs appeared most commonly in level II. The incidences of extra-cervical lymphadenopathy in abdomen, pelvis, inguina, axilla and mediastinum with available images were respectively 52.9{\%} (9/17), 47.1{\%} (8/17), 41.2{\%} (7/17), 30.6{\%} (11/36) and 14.3{\%} (8/56). When compared to cases with solitary cervical lymphadenopathy, the cases with extra-cervical lymphadenopathy had significantly greater incidences of bilateral cervical lymphadenopathy (P =.0379) and leukopenia (P =.0173). Conclusion: Unilateral cervical lymphadenopathy was the most frequent form of LNs involvement of KD. Extra-cervical lymphadenopathy was not uncommon and was associated with the appearance of bilateral distribution of cervical LNs and leukopenia.",
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T1 - Distribution of lymphadenopathy in patients with Kikuchi disease

AU - Chen, Lung Chiung

AU - Wang, Chao Jan

AU - Chang, Yu Chuan

AU - Shie, Shian Sen

AU - Lin, Tzou Yien

AU - Hsieh, Yu Chia

AU - Arthur Huang, Kuan Ying

AU - Kuo, Chen Yen

AU - Chiu, Cheng Hsun

AU - Huang, Yhu Chering

AU - Chen, Chih Jung

PY - 2019/1/1

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N2 - Background: Cervical lymphadenopathy is among the cardinal manifestations of Kikuchi disease (KD). The incidences and locations of extra-cervical lymph nodes (LNs) involvement in KD have not been comprehensively reported. Methods: From 2003 to 2016, 60 patients with pathologically confirmed KD and with computed tomography and/or whole-body inflammation scans at diagnosis were retrospectively identified. The locations, sizes and characteristics of all affected LNs were analyzed by extensive review of the image studies. The clinical and laboratory parameters were abstracted from medical records and the associations with extra-cervical LNs involvement were identified. Results: Female accounted for 35 (58.3%) patients and the median age of all patients was 21.3 years (ranges, 3–64 years). Of 59 patients with evaluable neck images, 42 (71.2%) and 16 (27.1%) patients presented with unilateral and bilateral nodal involvement, respectively, with the most common locations at level II, III and IV by Som's classification. The largest LNs appeared most commonly in level II. The incidences of extra-cervical lymphadenopathy in abdomen, pelvis, inguina, axilla and mediastinum with available images were respectively 52.9% (9/17), 47.1% (8/17), 41.2% (7/17), 30.6% (11/36) and 14.3% (8/56). When compared to cases with solitary cervical lymphadenopathy, the cases with extra-cervical lymphadenopathy had significantly greater incidences of bilateral cervical lymphadenopathy (P =.0379) and leukopenia (P =.0173). Conclusion: Unilateral cervical lymphadenopathy was the most frequent form of LNs involvement of KD. Extra-cervical lymphadenopathy was not uncommon and was associated with the appearance of bilateral distribution of cervical LNs and leukopenia.

AB - Background: Cervical lymphadenopathy is among the cardinal manifestations of Kikuchi disease (KD). The incidences and locations of extra-cervical lymph nodes (LNs) involvement in KD have not been comprehensively reported. Methods: From 2003 to 2016, 60 patients with pathologically confirmed KD and with computed tomography and/or whole-body inflammation scans at diagnosis were retrospectively identified. The locations, sizes and characteristics of all affected LNs were analyzed by extensive review of the image studies. The clinical and laboratory parameters were abstracted from medical records and the associations with extra-cervical LNs involvement were identified. Results: Female accounted for 35 (58.3%) patients and the median age of all patients was 21.3 years (ranges, 3–64 years). Of 59 patients with evaluable neck images, 42 (71.2%) and 16 (27.1%) patients presented with unilateral and bilateral nodal involvement, respectively, with the most common locations at level II, III and IV by Som's classification. The largest LNs appeared most commonly in level II. The incidences of extra-cervical lymphadenopathy in abdomen, pelvis, inguina, axilla and mediastinum with available images were respectively 52.9% (9/17), 47.1% (8/17), 41.2% (7/17), 30.6% (11/36) and 14.3% (8/56). When compared to cases with solitary cervical lymphadenopathy, the cases with extra-cervical lymphadenopathy had significantly greater incidences of bilateral cervical lymphadenopathy (P =.0379) and leukopenia (P =.0173). Conclusion: Unilateral cervical lymphadenopathy was the most frequent form of LNs involvement of KD. Extra-cervical lymphadenopathy was not uncommon and was associated with the appearance of bilateral distribution of cervical LNs and leukopenia.

KW - Computed tomography

KW - Kikuchi disease

KW - Lymphadenopathy

KW - Nuclear medicine

KW - Taiwan

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