Kikuchi-fujimoto disease mimicking malignant lymphoma with 2-[18F]fluoro-2-deoxy-D-glucose PET/CT in children

Kikuchi-fujimoto disease mimicking malignant lymphoma with 2-[18F]fluoro-2-deoxy-D-glucose PET/CT in children
C reactive protein; fluorodeoxyglucose f 18; hemoglobin; lactate dehydrogenase; adolescent; article; bone marrow biopsy; child; computer assisted emission tomography; erythrocyte sedimentation rate; female; histopathology; human; human tissue; Kikuchi disease; leukopenia; lymphadenopathy; lymphoma; major clinical study; male; pancytopenia; PET-CT scanner; preschool child; radiological parameters; retrospective study; school child; standardized uptake value
Issue Date
Korean Journal of Pediatrics, v.57, no.5, pp.226 - 231
Purpose: Kikuchi-Fujimoto disease (KFD) is a benign disease, which is characterized by a cervical lymphadenopathy with fever, and it often mimics malignant lymphoma (ML). 2-[18F]fluoro-2-deoxy-Dglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is a powerful imaging modality for the diagnosis, staging and monitoring of ML, with the limitations including the nonspecific FDG uptake in infectious or inflammatory processes. This study compared clinical manifestations and PET/CT findings between KFD and ML patients. Methods: We retrospectively reviewed the medical records of 23 patients with KFD and 33 patients with ML, diagnosed histopathologically, between January 2000 and May 2013 at the Department of Pediatrics, Yeungnam University Medical Center. Among them, we analyzed the clinical manifestations, laboratory findings and characteristics, and the amount of 18F-FDG uptake between 8 KFD and 9 ML patients who had 18F-FDG PET/CT. Results: The 18F-FDG PET/CT maximum standardized uptake values (SUVmax) ranged from 8.3 to 22.5 (mean, 12.0) in KFDs, and from 5.8 to 34.3 (mean, 15.9) in MLs. There were no significant differences in SUVmax between KFDs and MLs. 18F-FDG PET/CT with ML patients showed hot uptakes in the extranodal organs, such as bone marrow, small bowel, thymus, kidney, orbit and pleura. However, none of the KFD cases showed extranodal uptake (P<0.001). 18F-FDG PET/CT findings of KFD with nodal involvement only were indistinguishable from those of ML. Conclusion: Patients who had extranodal involvement on PET/CT were more likely to have malignancy than KFD. ? 2014 by The Korean Pediatric Society.
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