title: Differentiation of tuberculosis from lymphomas in neck lymph nodes with multidetector-row computed tomography.
abstract: BACKGROUND
  Tuberculosis (TB) of the cervical lymph nodes may mimic lymphoma.
  
  
  OBJECTIVE
  To evaluate multidetector-row computed tomographic (MDCT) imaging criteria for differentiating between the two diseases.
  
  
  METHODS
  We retrospectively reviewed the anatomical distribution  and CT enhancement patterns of the nodes in 81 patients, 27 (33%) with untreated TB and 54 (67%) with untreated lymphomas involving cervical lymph nodes. Of the patients with lymphomas, 19 (35%) had Hodgkin's disease and 35 (65%) had non-Hodgkin's lymphoma.
  
  
  RESULTS
  TB predominantly involved  the upper cervical nodes. The supraclavicula fossa nodes on MDCT were involved more often in Hodgkin's disease (n = 15, 79%) and non-Hodgkin's lymphoma (n = 25, 71%) than in TB (n = 3, 11%). Tuberculous lymphadenopathy commonly showed peripheral enhancement, frequently  with a multilocular appearance. Peripheral enhancement was significantly more frequent in TB (n = 19, 70%) than in Hodgkin's disease (n = 1, 5%) and non-Hodgkin's lymphoma (n = 1, 3%), but homogeneous enhancement was less common in the TB group.
  
  
  CONCLUSIONS
  Our findings  indicate that a specific enhancement pattern of lymphadenopathy seen on MDCT was useful in differentiating between untreated TB and lymphomas of the cervical lymph nodes.
authors.affiliation: Department of Radiology, West China Hospital, Sichuan University, Chengdu, China.
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.forename: Z-G
authors.initials: ZG
authors.lastname: Yang
authors.forename: H
authors.initials: H
authors.lastname: Shao
authors.forename: J-H
authors.initials: JH
authors.lastname: Xiao
authors.forename: W
authors.initials: W
authors.lastname: Deng
authors.forename: L-Y
authors.initials: LY
authors.lastname: Wen
authors.forename: S-S
authors.initials: SS
authors.lastname: Tang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D016009:Chi-Square Distribution; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D005260:Female; D006689:Hodgkin Disease / Q000000981:diagnostic imaging* / Q000473:pathology; D006801:Humans; D007223:Infant; D008198:Lymph Nodes / Q000000981:diagnostic imaging* / Q000473:pathology; D008228:Lymphoma, Non-Hodgkin / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography; D009333:Neck; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014388:Tuberculosis, Lymph Node / Q000000981:diagnostic imaging* / Q000473:pathology; D055815:Young Adult