Kim Ji Young, Lee Hyunju, Yun Bo La
Department of Radiology, Seoul National University Bundang Hospital, Seongnam, Korea.
Department of Pediatrics, Seoul National University Bundang Hospital, Seongnam, Korea.
Ultrasonography. 2017 Jan;36(1):66-70. doi: 10.14366/usg.16047. Epub 2016 Dec 2.
The purpose of this study was to analyze the ultrasonographic (USG) findings of Kikuchi cervical lymphadenopathy in pediatric patients.
Between April 2007 and September 2016, 84 children (42 male and 42 female; mean±standard deviation age, 12.9±3.2 years; range, 5 to 18 years) confirmed with Kikuchi disease were enrolled. Clinical findings and USG findings of Kikuchi cervical lymphadenopathy were retrospectively reviewed. Localized symptoms, systemic symptoms, and laboratory findings including the white blood cell count, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) were analyzed. An analysis of the USG findings included evaluation of the location, size, and presence of intranodal abscess; intranodal calcification; perinodal fat swelling; localized fluid collection; and loss of nodal echogenic hilum.
Among the patients, 49 (58%) showed localized tenderness at the cervical lymphadenopathy. Fever was present in 55 (66%), while 27 (32%) had prolonged fever. Of 74 with lab results, 54 (73%) had leukopenia but none had leukocytosis. Among the same 74, there was a high ESR (>50 mm/hr) in 10 (14%) and a high CRP level (>5 mg/dL) in seven (9%). The USG findings of most of the patients (n=72, 86%) showed unilateral neck involvement, especially in the left side neck (45 of 72, 63%). The most common site of Kikuchi lymphadenopathy involvement was the area at cervical lymph node level V, at the posterior triangle (n=77, 92%). Conglomerated nodal distribution (n=57, 68%), preserved central nodal echogenic hilum (n=84, 98%), and perinodal fat swelling (n=55, 65%) were common USG findings in the children with Kikuchi. In addition, multiple cervical lymph nodes showed a relatively even size distribution (n=73, 87%).
The common USG findings of Kikuchi disease in the pediatric population of our study were multiple conglomerated unilateral cervical lymphadenopathy showing perinodal fat swelling and even size distribution.
本研究旨在分析小儿菊池颈部淋巴结病的超声检查（USG）结果。
纳入2007年4月至2016年9月间确诊为菊池病的84例儿童（男42例，女42例；平均年龄±标准差为12.9±3.2岁；范围为5至18岁）。对菊池颈部淋巴结病的临床表现和超声检查结果进行回顾性分析。分析局部症状、全身症状以及包括白细胞计数、红细胞沉降率（ESR）和C反应蛋白（CRP）在内的实验室检查结果。超声检查结果分析包括评估淋巴结的位置、大小、有无淋巴结内脓肿、淋巴结内钙化、淋巴结周围脂肪肿胀、局限性液体积聚以及淋巴结回声性门部消失情况。
患者中，49例（58%）颈部淋巴结病表现为局部压痛。55例（66%）出现发热，其中27例（32%）有长期发热。在74例有实验室检查结果的患者中，54例（73%）有白细胞减少，但无白细胞增多。在这74例患者中，10例（14%）红细胞沉降率高（>50 mm/h），7例（9%）C反应蛋白水平高（>5 mg/dL）。大多数患者（n = 72，86%）的超声检查结果显示单侧颈部受累，尤其是左侧颈部（72例中的45例，63%）。菊池淋巴结病最常累及的部位是颈部V区后三角处（n = 77，92%）。融合性淋巴结分布（n = 57，68%）、中央淋巴结回声性门部保留（n = 84，98%）以及淋巴结周围脂肪肿胀（n = 55，65%）是菊池病患儿常见的超声检查结果。此外，多个颈部淋巴结大小分布相对均匀（n = 73，87%）。
在我们研究的小儿群体中，菊池病常见的超声检查结果是多个融合性单侧颈部淋巴结病，表现为淋巴结周围脂肪肿胀和大小分布均匀。
