Clinical and Experimental Pediatrics

The Korean Pediatric Society (대한소아청소년과학회)
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Kikuchi-Fujimoto disease mimicking malignant lymphoma with 2-[$^{18}F$]fluoro-2-deoxy-D-glucose PET/CT in children

  • Kim, Ji Eun (Department of Pediatrics, Yeungnam University College of Medicine) ;
  • Lee, Eun Kyung (Department of Pediatrics, Yeungnam University College of Medicine) ;
  • Lee, Jae Min (Department of Pediatrics, Yeungnam University College of Medicine) ;
  • Bae, Soon Hwan (Department of Pediatrics, Yeungnam University College of Medicine) ;
  • Choi, Kwang Hae (Department of Pediatrics, Yeungnam University College of Medicine) ;
  • Lee, Young Hwan (Department of Pediatrics, Yeungnam University College of Medicine) ;
  • Hah, Jeong Ok (Department of Pediatrics, Yeungnam University College of Medicine) ;
  • Choi, Joon Hyuk (Department of Surgical Pathology, Yeungnam University College of Medicine) ;
  • Kong, Eun Jung (Department of Nuclear Medicine, Yeungnam University College of Medicine) ;
  • Cho, Ihn Ho (Department of Nuclear Medicine, Yeungnam University College of Medicine)
  • Received : 2013.05.28
  • Accepted : 2013.10.05
  • Published : 2014.05.15
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Abstract

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-[$^{18}F$]fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ($^{18}F$-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 $^{18}F$-FDG uptake between 8 KFD and 9 ML patients who had $^{18}F$-FDG PET/CT. Results: The $^{18}F$-FDG PET/CT maximum standardized uptake values ($SUV_{max}$) 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 $SUV_{max}$ between KFDs and MLs. $^{18}F$-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). $^{18}F$-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.

Keywords

References

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