title: Differentiation between tuberculosis and leukemia in abdominal and pelvic lymph nodes: evaluation with contrast-enhanced multidetector computed tomography.
abstract: OBJECTIVE
  To compare the characteristics of tubercular vs. leukemic involvement of abdominopelvic lymph nodes using multidetector computed tomography (CT).
  
  
  METHODS
  We retrospectively reviewed multidetector computed tomography features including lymph node size, shape, enhancement patterns, and anatomical distribution, in 106 consecutive patients with newly diagnosed, untreated tuberculosis (55 patients; 52%) or leukemia (51 patients; 48%). In patients with leukemia, 32 (62.7%) had chronic lymphocytic leukemia, and 19 (37.3%) had acute leukemias; of these, 10 (19.6%) had acute myeloid leukemia, and 9 (17.6%) had acute lymphocytic leukemia.
  
  
  RESULTS
  The lower para-aortic (30.9% for tuberculosis, 63.2% for acute leukemias and 87.5% for chronic lymphocytic leukemia) and inguinal (9.1% for tuberculosis, 57.9% for acute leukemias and 53.1% for chronic lymphocytic leukemia) lymph nodes were involved more frequently in the three types of leukemia than in tuberculosis (both with p <0.017). Tuberculosis showed peripheral enhancement, frequently with a multilocular appearance, in 43 (78.2%) patients, whereas patients with leukemia (78.9% for acute myeloid leukemia and acute lymphocytic leukemia, 87.5% for chronic lymphocytic leukemia) demonstrated predominantly homogeneous enhancement (both with p <0.017). For the diagnosis of tuberculosis, the analysis showed that a peripheral enhancement pattern had a sensitivity of 78.2%, a specificity of 100%, and an accuracy of 88.7%. For the diagnosis of leukemia, the analysis showed that a homogeneous enhancement pattern was associated with a sensitivity of 84.3%, a specificity of 94.5%, and an accuracy of 89.6%.
  
  
  CONCLUSIONS
  Our findings indicate that the anatomical distribution and enhancement patterns of lymphadenopathy seen on multidetector computed tomography are useful for differentiating between untreated tuberculosis and leukemia of the abdominopelvic lymph nodes.
authors.affiliation: West China Hospital, Department of Radiology, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Ge
authors.initials: G
authors.lastname: Zhang
authors.affiliation: West China Hospital, Department of Radiology, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Zhi-gang
authors.initials: ZG
authors.lastname: Yang
authors.affiliation: West China Hospital, Department of Radiology, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Jin
authors.initials: J
authors.lastname: Yao
authors.affiliation: West China Hospital, Department of Radiology, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Wen
authors.initials: W
authors.lastname: Deng
authors.affiliation: West China Hospital, Department of Radiology, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Shuai
authors.initials: S
authors.lastname: Zhang
authors.affiliation: West China Hospital, Department of Radiology, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Hua-yan
authors.initials: HY
authors.lastname: Xu
authors.affiliation: West China Hospital, Department of Radiology, Sichuan University, Chengdu, Sichuan, China.
authors.forename: Qi-hua
authors.initials: QH
authors.lastname: Long
mesh_terms: D000005:Abdomen; D000293:Adolescent; D000328:Adult; D000368:Aged; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007938:Leukemia / Q000000981:diagnostic imaging* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D010388:Pelvis; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014388:Tuberculosis, Lymph Node / Q000000981:diagnostic imaging* / Q000473:pathology; D055815:Young Adult
chemical_list: D003287:Contrast Media