Hemophagocytic lymphohistiocytosis preceded by Kikuchi disease in children

Background Kikuchi disease (KD) is a type of benign, self-limiting lymphadenitis, but it has also been associated with hemophagocytic lymphohistiocytosis (HLH). To date, only a few reports have suggested an association between HLH and KD. Objective To report the imaging findings and clinical charact...

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Bibliographic Details
Published in:Pediatric radiology 2008-07, Vol.38 (7), p.756-761
Main Authors: Lim, Gye-Yeon, Cho, Bin, Chung, Nak Gyun
Format: Article
Language:English
Subjects:
Adolescent
Child
Child, Preschool
Contrast Media
Female
Histiocytic Necrotizing Lymphadenitis - complications
Histiocytic Necrotizing Lymphadenitis - diagnostic imaging
Humans
Imaging
Lymphohistiocytosis, Hemophagocytic - diagnostic imaging
Lymphohistiocytosis, Hemophagocytic - etiology
Male
Medicine
Medicine & Public Health
Neuroradiology
Nuclear Medicine
Oncology
Original Article
Pediatrics
Radiology
Retrospective Studies
Tomography, X-Ray Computed
Ultrasonography
Ultrasound
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Summary:Background Kikuchi disease (KD) is a type of benign, self-limiting lymphadenitis, but it has also been associated with hemophagocytic lymphohistiocytosis (HLH). To date, only a few reports have suggested an association between HLH and KD. Objective To report the imaging findings and clinical characteristics of KD accompanied by HLH in children. Materials and methods Five children with a prolonged fever and cervical lymphadenopathy were diagnosed as having HLH accompanied by KD. The authors retrospectively analyzed the clinical characteristics and the imaging findings in these children. The histology of excision biopsy samples of cervical lymph nodes in all children confirmed the diagnosis of KD. HLH was confirmed by bone marrow biopsy and laboratory criteria provided by the Histiocyte Society. Results The greatest dimension of the enlarged nodes ranged from 0.5 cm to 2.5 cm and the nodes were most frequently located at level V. CT scans visualized perinodal infiltrates in most of the affected cervical nodes (four of five children) and extracervical nodes (three of three children). On enhanced CT scans, nonenhancing necrosis within the affected cervical nodes was noted in three children. Conclusion KD might be related to HLH in children. Systemic evaluations and follow-up of children with KD might help to identify HLH related to KD.
ISSN:0301-0449
1432-1998
DOI:10.1007/s00247-008-0894-x