Cervical atypical mycobacterial lymphadenitis in childhood: findings on sonography.
OBJECTIVE
To describe the sonographic appearance of cervical lymph nodes in twelve children with histopathologically confirmed atypical mycobacterial lymphadenitis.


METHODS
Sonography of cervical lymph nodes was performed with a real-time linear scanner using a 13 MHz probe. Sonographic findings were retrospectively reviewed in 9 girls and 3 boys age 1.7 to 10.7 years (median age, 3.7 years), with cervical lymphadenopathy at initial presentation.


RESULTS
Strong echoes within the lymph nodes were found in 4 (33 %) of the children, corresponding to calcifications on histopathological examination. Loss of regular nodal shape with circumscript polypoid spread of nodal masses into the subcutaneous tissue was found in 6 (50 %) patients; at least 1 of these 2 features was noted in 10 (83 %) of our 12 patients. At surgery, abscess formation was found in 8 (67 %) children.


CONCLUSIONS
When nodal calcifications and spread of nodal masses into the subcutaneous tissue are found in patients with cervical lymphadenopathy, the examiner should maintain a high level of clinical suspicion for atypical mycobacterial lymphadenitis. Contrary to other causes of cervical lymphadenopathy, total surgical excision is the treatment of choice. Identification of these patients prior to surgery is therefore of utmost importance. Our data suggest that sonography could serve as an easy non-invasive method for this purpose.
Haber
H P
HP
Department of Paediatrics, University of Tübingen, Hoppe-Seyler-Strasse 1, 72076 Tübingen, Germany. peter.haber@med.uni-tuebingen.de
Warmann
S W
SW
Fuchs
J
J
D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000382:microbiology; D008297:Male; D009165:Mycobacterium Infections, Nontuberculous / Q000000981:diagnostic imaging* / Q000601:surgery; D014388:Tuberculosis, Lymph Node / Q000000981:diagnostic imaging* / Q000601:surgery; D014463:Ultrasonography; D002577:Uterine Cervical Diseases / Q000000981:diagnostic imaging / Q000382:microbiology* / Q000601:surgery