Clinical significance of enlarged perihepatic lymph node on ultrasonography.
OBJECTIVE
To determine the relation between enlarged perihepatic lymph node (PLN) and viraemia, and to find out whether there is a difference in PLN size between the healthy individuals and patients with hepatitis C virus (HCV) infection.


METHODS
Seventy-four outpatients with HCV infection were primarily enrolled into the study. As controls, 283 individuals who had medical check-ups by ultrasonography without liver disease were also examined. The length and thickness of lymph node were measured. The lymph-node index (LN index) was calculated by multiplying the length and thickness of the lymph node. This index was then compared with serum HCV core antigen (HCV-Ag) levels. According to the level of HCV-Ag, we defined grade I as negative, grade II as minimal, grade III as medium and grade IV as extensive.


RESULTS
LN index of 100 mm2 or more was found in 83.3% (50 of 60) of patients with hepatitis C, and LN index less than 100 mm2 in 90.9% (101 of 111) of controls. LN index showed a significant correlation with HCV-Ag level (r=0.436, P<0.05). No significant differences were found between LN index and HCV-Ag grade, but LN index increased in patients with grade IV [mean 160.0 mm2 (SD 50.86)] compared to grade I [57.0 mm2 (SD 98.73)], grade II [95.3 mm2 (SD 65.32)] and grade III [149.7 mm2 (SD 41.09)].


CONCLUSIONS
Perihepatic lymphadenopathy indicates viraemia, and LN index seems to be useful in estimating whether patients have hepatitis C infection or are healthy.
Watanabe
Tsuneo
T
Department of Clinical Laboratory, Gifu Social Insurance Hospital, Dota, Kani Gifu, Japan. tsuneo.w1112@s9.dion.ne.jp
Sassa
Toshi
T
Hiratsuka
Hiroe
H
Hattori
Shinichi
S
Abe
Akira
A
D000328:Adult; D005260:Female; D018936:Hepatitis C Antigens / Q000097:blood; D019698:Hepatitis C, Chronic / Q000150:complications* / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging / Q000473:pathology / Q000821:virology*; D008297:Male; D008875:Middle Aged; D012372:ROC Curve; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D014463:Ultrasonography; D014766:Viremia / Q000150:complications
D018936:Hepatitis C Antigens