Differentiation of tuberculosis from lymphomas in neck lymph nodes with multidetector-row computed tomography

• Published in: The international journal of tuberculosis and lung disease Vol. 16; no. 12; pp. 1686 - 1691
• Main Authors: Chen, J., Yang, Z-G., Shao, H., Xiao, J-H., Deng, W., Wen, L-Y., Tang, S-S.
• Format: Journal Article
• Language: English
• Published: Paris, France International Union Against Tuberculosis and Lung Disease 01.12.2012; International Union against Tuberculosis and Lung Disease
• Subjects: Adolescent; Adult; Aged; Aged, 80 and over; Bacterial diseases; Biological and medical sciences; Biopsy; Cervical Lymph Node; Chi-Square Distribution; Child; Child, Preschool; Computed Tomography; Diagnosis, Differential; Female; Hematologic and hematopoietic diseases; Hodgkin Disease - diagnostic imaging; Hodgkin Disease - pathology; Human bacterial diseases; Humans; Infant; Infectious diseases; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Lymph Nodes - diagnostic imaging; Lymph Nodes - pathology; Lymphoma; Lymphoma, Non-Hodgkin - diagnostic imaging; Lymphoma, Non-Hodgkin - pathology; Male; Medical sciences; Middle Aged; Multidetector Computed Tomography; Mycobacterium; Neck; Pneumology; Predictive Value of Tests; Retrospective Studies; Sensitivity and Specificity; Tuberculosis; Tuberculosis and atypical mycobacterial infections; Tuberculosis, Lymph Node - diagnostic imaging; Tuberculosis, Lymph Node - pathology; Young Adult; computed tomography; Radiodiagnosis; Lymph node; Malignant hemopathy; Mycobacterial infection; Lymphoma; Infection; Multidetector scanner; Tuberculosis; Lymphoproliferative syndrome; Bacteriosis; Cervical ganglion; Medical imagery; Computerized axial tomography; Neck; Differentiation; cervical lymph node; Cancer; Pneumology
• ISSN: 1027-3719; 1815-7920
• DOI: 10.5588/ijtld.12.0204

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.MATERIALS AND 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.CONCLUSION: 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.