Ultrasound detection of abdominal lymph nodes in chronic liver diseases. A retrospective analysis.
OBJECTIVE
To retrospectively evaluate the prevalence of lymph nodes of the hepato-duodenal ligament in a group of patients with chronic liver disease of various aetiologies and to investigate what clinical, aetiological and laboratory data may lead to their appearance.


METHODS
One thousand and three patients (554 men, 449 women) were studied, including 557 with chronic hepatitis and 446 with liver cirrhosis. The presence of lymph nodes near the trunk of the portal vein, hepatic artery, celiac axis, superior mesenteric vein and pancreas head was investigated using ultrasound.


RESULTS
Lymph nodes were detected in 394 out of the 1003 study patients (39.3%); their number ranged from one to four, with a diameter ranging between 0.8 and 4 cm. The highest prevalence was in the subgroup of patients with primary biliary cirrhosis (87.5%), followed by patients with hepatitis C virus (HCV; 42%), patients with HCV and hepatitis B virus (HBV; 41.3%), autoimmune hepatitis (40%), and HBV alone (21.2%). In the alcoholic and idiopathic subgroups prevalence was 9.5%, while in the non-alcoholic steatohepatitis and haemochromatosis subgroups it was 0%. HCV RNA was present in 97 out of 103 lymph node-positive patients and in 141 out of 168 lymph node-negative HCV-negative patients (p<0.003). Lymphadenopathy frequency increased as the liver disease worsened (chi(2) MH=74.3; p<0.0001).


CONCLUSIONS
Despite the limitations of a retrospective study, our data indicate a high prevalence of lymphadenopathy in liver disease patients; ultrasound evidence of lymph nodes of the hepato-duodenal ligament in a given liver disease may most likely suggest a HCV or an autoimmune aetiology and a more severe histological picture.
Cattedra di Medicina Interna, Università di Palermo, via del Vespro 141, 90127, Palermo, Italy.
M
M
Soresi
G
G
Bonfissuto
C
C
Magliarisi
A
A
Riili
A
A
Terranova
G
G
Di Giovanni
F
F
Bascone
A
A
Carroccio
S
S
Tripi
G
G
Montalto
D000005:Abdomen / Q000000981:diagnostic imaging; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005260:Female; D006432:Hemochromatosis / Q000000981:diagnostic imaging / Q000378:metabolism; D006505:Hepatitis / Q000000981:diagnostic imaging / Q000378:metabolism; D006801:Humans; D008103:Liver Cirrhosis / Q000000981:diagnostic imaging / Q000378:metabolism; D008107:Liver Diseases / Q000150:complications / Q000000981:diagnostic imaging* / Q000378:metabolism; D008108:Liver Diseases, Alcoholic / Q000000981:diagnostic imaging / Q000378:metabolism; D008111:Liver Function Tests; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008206:Lymphatic Diseases / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014463:Ultrasonography