title: Diagnostic accuracy of the clinical and CT findings for differentiating Kikuchi's disease and tuberculous lymphadenitis presenting with cervical lymphadenopathy.
abstract: OBJECTIVE
  To determine the optimal clinical and CT findings for differentiating Kikuchi's disease (KD) and tuberculous lymphadenitis (TB) in patients presenting with cervical lymphadenopathy.
  
  
  METHODS
  From 2006 to 2010, 87 consecutive patients who were finally diagnosed with KD or TB were enrolled. Two radiologists performed independent analysis of contrast-enhanced neck CT images with regard to the involvement pattern, nodal or perinodal changes, and evidence of the previous infection. Significant clinical and CT findings of KD were determined by statistical analyses.
  
  
  RESULTS
  Of the 87 patients, 27 (31%) were classified as having KD and 60 (69%) as having TB. Statistically significant findings of KD patients were younger age, presence of fever, involvement of ≥5 nodal levels or the bilateral neck, no or minimal nodal necrosis, marked perinodal infiltration, and no evidence of upper lung lesion or mediastinal lymphadenopathy. The presence of four or more statistically significant clinical and CT findings of KD had the largest area under the receiver-operating characteristic curve (A z = 0.861; 95% confidence intervals 0.801, 0.909), with a sensitivity of 89% and specificity of 83%.
  
  
  CONCLUSIONS
  CT can be a helpful tool for differentiating KD from TB, especially when it is combined with the clinical findings.
authors.affiliation: Department of Radiology and Research Institute of Radiology, University of Ulsan College of Medicine, Asan Medical Center, 86 Asanbyeongwon-Gil, Songpa-Gu, Seoul, 138-736, Republic of Korea.
authors.forename: Hye Jin
authors.initials: HJ
authors.lastname: Baek
authors.forename: Jeong Hyun
authors.initials: JH
authors.lastname: Lee
authors.forename: Hyun Kyung
authors.initials: HK
authors.lastname: Lim
authors.forename: Ha Young
authors.initials: HY
authors.lastname: Lee
authors.forename: Jung Hwan
authors.initials: JH
authors.lastname: Baek
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D020042:Histiocytic Necrotizing Lymphadenitis / Q000000981:diagnostic imaging*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007479:Iopamidol; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging; D008297:Male; D008875:Middle Aged; D009333:Neck / Q000000981:diagnostic imaging; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014388:Tuberculosis, Lymph Node / Q000000981:diagnostic imaging*; D055815:Young Adult
chemical_list: D003287:Contrast Media; D007479:Iopamidol