It is often not possible to tell the cause of the lymph node enlargement without a biopsy. Enlarged lymph nodes can also occur because of spread of cancer, infections, inflammatory conditions or more generalized illnesses. When lymph nodes are markedly enlarged and matted, than lymphoma becomes the main consideration. These infections will often be apparent to the clinical doctor.Įnlarged lymph nodes in the pelvis on CT can therefore have many causes. Ulcers or infections of the skin result in enlarged lymph nodes on CT. Infections like Syphilis, flu, fungus can cause more generalized lymph node enlargement.More systemic conditions will result in more generalized enlarged lymph nodes not isolated to the pelvis.Įnlarged lymph nodes in the pelvis are common when there are infections or inflammatory conditions of the legs and feet. Autoimmune conditions like lupus or arthritis like rheumatoid can cause lymphadenopathy. Often there will be a history of cancer or associated findings.Įnlarged lymph nodes in the pelvis on CT can be seen with systemic infections like HIV/AIDS which can cause lymphadenopathy in the body. Many types of cancer produce enlarged lymph nodes in the pelvis on CT but some of the more common ones are prostate cancer, gynecological cancer, and cancers of the extremities. Spread of cancer to the lymph nodes in the pelvis is another cause of enlarged lymph nodes. Lymphoma staging often involves imaging the body with CT or PET scan. Lymphoma is a blood cancer and can be limited to the nodes or involve structures outside the lymph nodes. Multiple markedly enlarged lymph nodes in the pelvis that are greater than say 2 centimeters and matted raise concern for something like lymphoma. Unfortunately, distinguishing those lymph nodes that are from benign conditions and cancer may not be possible without biopsy. Enlarged lymph nodes in the pelvis are those which are abnormally shaped or larger than typical. Such nodes when found in an otherwise healthy population are clinically insignificant and require no further imaging.Enlarged lymph nodes on CT in the pelvis can be present because of infections, inflammatory conditions, cancer, or even medications. In general, these nodes are small, measuring less than 5 mm. Incidental finding of mesenteric lymph nodes is common, reflecting more widespread use of thin-collimation MDCT and PACS workstations. Nodes were identified in more than one location in two patients (4%). These nodes were identified only at the mesenteric root in 32 patients (68%), only in the mesenteric periphery in eight patients (17%), and only in the right lower quadrant in five patients (11%). The mean size of the largest nodes was 4.8 mm (range, 3-9 mm), and the mean size of the nodes found per patient was 3.6 mm (range, 3-6 mm). Twenty-five (53%) of the 47 patients had four or fewer nodes. Of these 47 patients, 22 (47%) had five or more lymph nodes detected. Of the 120 patients with otherwise normal CT scans, 47 had mesenteric lymph nodes greater than 3 mm. All studies were reviewed on a PACS workstation. Lymph node size, number, and location (central, peripheral, or right lower quadrant) were documented. Two radiologists evaluated the images by consensus and recorded the presence of mesenteric lymph nodes greater than 3 mm in the short axis. All imaging was performed using 3.2-mm collimation on MDCT scanners with IV contrast material. Twelve patients were excluded because they had disease processes known to be associated with lymphadenopathy. We examined the CT scans of 132 consecutive patients (84 men and 36 women age range, 12-90 years mean age, 43 years) who presented to the emergency department after experiencing blunt abdominal trauma. The purpose of this study is to document the incidence of mesenteric lymph nodes in a previously healthy population and to provide guidelines for further management. What to do with these findings has not been well established. Unsuspected mesenteric lymph nodes are frequently found on abdominal CT scans in everyday clinical practice.
0 Comments
Leave a Reply. |