Journal of Ultrasound in Medicine, Vol 15, Issue 5 353-359, Copyright © 1996 by American Institute of Ultrasound in Medicine
Abdominal lymphadenopathy in benign diseases: sonographic detection and clinical significance
P. Gimondo, P. Mirk, G. Messina and C. Pizzi
Servizio di Diagnostica per Immagini, Ospedale S. Sebastiano M., Rome, Italy.
We prospectively evaluated the frequency of lymphadenopathy in the right
upper abdominal quadrant as detected by sonography in 650 consecutive
unselected patients, after excluding patients with a known lymphoma or
abdominal carcinoma and patients with acquired immunodeficiency disease.
Evidence of enlarged lymph nodes (few in number, with an elongated shape
and isoechoic to the liver, 8 to 22 mm in size), found primarily in the
gastrohepatic ligament and porta hepatis, was seen on sonographic scans in
106 patients (16.3%). Associated conditions in 69 of 106 patients (65%)
were hepatobiliary or pancreatic diseases and, less frequently, other
benign entities (12 patients; 11.3%); in 25 cases (23.5%) no significant
abdominal or systemic disease was present. Comparison with CT or surgical
findings, or both, was available in 36 cases. We conclude that
lymphadenopathy in the right upper abdominal quadrant may be found in
relation to different non-neoplastic conditions as well as in the absence
of any significant intra-abdominal disease. The frequency of this finding
on sonographic scans must be recognized to prevent misdiagnosis of lymphoma
or metastatic disease as well as to avoid overstaging of local
(hepatobiliary, pancreatic, gastric) neoplasms.
