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Copyright ©2008 The WJG Press and Baishideng. All rights reserved.
World J Gastroenterol. Jun 28, 2008; 14(24): 3914-3918
Published online Jun 28, 2008. doi: 10.3748/wjg.14.3914
Tuberculosis versus non-Hodgkin’s lymphomas involving small bowel mesentery: Evaluation with contrast-enhanced computed tomography
Peng Dong, Bin Wang, Quan-Ye Sun, Hui Cui
Peng Dong, Bin Wang, Quan-Ye Sun, Hui Cui, Department of Medical Imaging, Medical Imaging Centre of the Affiliated Hospital, Weifang Medical University, Weifang 261042, Shandong Province, China
Author contributions: Dong P, Wang B, Sun YQ and Cui H contributed equally to this work; Dong P, Wang B, Sun YQ and Cui H wrote the paper.
Correspondence to: Dong Peng, Department of Medical Imaging, Weifang Medical University, Weifang 261042, Shandong Province, China. dongpeng98021@sina.com
Telephone: +86-536-8068959
Fax: +86-536-8238243
Received: February 27, 2008
Revised: May 19, 2008
Accepted: May 26, 2008
Published online: June 28, 2008
Abstract

AIM: To evaluate the specific computed tomography (CT) imaging criteria for differentiating tuberculosis involving the small bowel mesenteric lymph nodes from lymphomas.

METHODS: We retrospectively reviewed the anatomic distribution, CT enhancement patterns of lymphoma in 18 patients with mesenteric tuberculosis and 22 with untreated non-Hodgkin’s lymphomas (NHL) involving small bowel mesentery (SBM). Of the 18 patients with tuberculosis, 9 had purely mesenteric tuberculous lymphadenopathy (TL), and 9 had mesenteric TL accompanied with tuberculous mesenteritis (TLM).

RESULTS: CT showed that tuberculosis and NHL mainly affected lymph nodes in the body and root of SBM. Homogeneously enhanced lymph nodes in the body and root of SBM were found more often in the NHL (P < 0.05). Homogeneously mixed peripheral enhanced lymph nodes in the body of SBM were found more often in mesenteric TL and TLM (P < 0.05). Peripheral enhanced lymph nodes in the root of SBM were found more often in mesenteric TL and TLM (P < 0.01). “Sandwich sign” in the root of SBM was observed more often in NHL (P < 0.05).

CONCLUSION: Anatomic lymph node distribution, sandwich sign and specific enhancement patterns of lymphadenopathy in SBM on CT images can be used in differentiating between tuberculosis and untreated NHL involving SBM.

Keywords: Tuberculosis; Lymphoma; Mesentery; X-ray; Computed tomography