Disease spectrum of cervical lymphadenitis: Analysis based on ultrasound-guided core-needle gun biopsy

Objectives: Despite the high frequency of cervical lymphadenopathy in the outpatient clinics, there was no published data on the disease spectrum of cervical lymphadenopathy among adult outpatients. We are evaluating the disease spectrum of cervical lymphadenitis in the outpatient setting. Methods: As for the patients with cervical lymphadenitis, ultrasound-guided core-needle gun biopsy has been performed in Korea University Hospital. We reviewed medical records of adult outpatients with cervical lymphadenitis between January 2004 and April 2006, and compared the clinical, laboratory and radiological differences among them. Results: The study included 147 patients with the mean age of 33.7 years. Histopathological diagnoses were obtained from 137 (93.2%) cases: Kikuchi's disease (34.7%), tuberculous lymphadenitis (22.4%), non-specific lymphadenitis (22.4%), lymphoma (6.1%), metastatic carcinoma (3.4%), etc. Overall, clinical manifestations were indistinguishable among tuberculous lymphadenitis, Kikuchi's disease and non-specific lymphadenitis. Leucopenia was characteristic of Kikuchi's disease, while anemia, thrombocytosis and pulmonary tuberculosis (irrespective of activity) were more common in the tuberculous lymphadenitis. Conclusion: Kikuchi's disease and tuberculosis were the most common and clinically important causes of cervical lymphadenitis. Complete blood count, chest X-ray and ultrasound-guided core-needle gun biopsy would be helpful in the differential diagnosis of cervical lymphadenitis, especially between Kikuchi's disease and tuberculous lymphadenitis.