Abstract
BACKGROUND: Nontuberculous mycobacteria (NTM) are a common cause of chronic cervicofacial lymphadenitis in young children. The differential diagnosis includes other infections, lymphoepithelial cysts and malignancies. OBJECTIVE: To assess the sonographic findings of NTM cervicofacial lymphadenitis in children. MATERIALS AND METHODS: We analysed the sonograms of cervicofacial lymph nodes of 145 children with microbiologically proven NTM lymphadenitis. RESULTS: The size of the involved lymph nodes ranged from 1.9 cm to 4.4 cm. Most of the NTM patients (85%) presented in a stage of lymph node fluctuation with violaceous skin discoloration. On sonography, marked decreased echogenicity was seen in all cases. In 133 of the patients (92%) liquefaction with intranodal cystic necrosis, nodal matting and adjacent soft-tissue oedema were present. 66 children received antibiotic treatment, and the other children underwent surgical excision of the involved lymph nodes. In 69% of the patients successfully treated with antibiotics, multiple intranodal calcifications were present on sonography after 1 year. CONCLUSIONS: Sonographic findings can provide additional diagnostic clues for NTM lymphadenitis in childhood. A marked decrease of echogenicity in the early stages, with intranodal liquefaction in the advanced stages, are universal features, albeit not entirely specific. Multiple intranodal calcifications are rather characteristic of end-stage mycobacterial infection
Original language | Undefined/Unknown |
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Pages (from-to) | 1063-1067 |
Journal | Pediatric Radiology |
Volume | 36 |
Issue number | 10 |
DOIs | |
Publication status | Published - 2006 |