Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Sep 21, 2011; 17(35): 4038-4043
Published online Sep 21, 2011. doi: 10.3748/wjg.v17.i35.4038
Neoplasm-like abdominal nonhematogenous disseminated tuberculous lymphadenopathy: CT evaluation of 12 cases and literature review
Ming Zhang, Min Li, Gui-Ping Xu, Hong-Juan Liu
Ming Zhang, Min Li, Gui-Ping Xu, Department of Medical Imaging, First Affiliated Hospital, Xi’an Jiaotong University School of Medicine, Xi’an 710061, Shaanxi Province, China
Hong-Juan Liu, Department of Intensive Care, First Affiliated Hospital, Xi’an Jiaotong University School of Medicine, Xi’an 710061, Shaanxi Province, China
Author contributions: Zhang M, Li M, Xu GP and Liu HJ contributed equally to this work; Liu HJ acquired the clinical material; Zhang M, Li M, Xu GP reviewed the CT findings; Zhang M, Li M and Liu HJ wrote the paper.
Correspondence to: Hong-Juan Liu, Associate Professor, Department of Intensive Care, First Affiliated Hospital, Xi’an Jiaotong University School of Medicine, Xi’an 710061, Shaanxi Province, China. lhj_xjtu@126.com
Telephone: +86-29-85324618 Fax: +86-29-85323248
Received: January 17, 2011
Revised: March 11, 2011
Accepted: March 18, 2011
Published online: September 21, 2011
Abstract

AIM: To assess the diagnostic value of computed tomography (CT) imaging in screening for abdominal nonhematogenous disseminated tuberculous lymphadenopathy (TL).

METHODS: The CT scans of 12 patients with abdominal nonhematogenous disseminated TL suggestive of neoplasm were retrospectively analyzed in this review. The final diagnoses were confirmed by lymph node pathology for seven patients and by laparoscopic surgery for five patients. All of the patients were treated at our institution between April 1995 and August 2009.

RESULTS: The sites of involvement were the periportal (n = 6), peripancreatic (n = 3), periaortic (n = 3), and mesenteric (n = 2) regions. On the plain CT scan, the lymphadenopathy showed a heterogeneous isodensity or hypodensity in 11 patients and a low density in one patient. Peripheral enhancement was observed on the dynamic contrast-enhanced CT scans for all patients. In two cases, scans were more revealing during the portal venous and delayed phases.

CONCLUSION: Abdominal lymphadenopathy with predominant peripheral rim-like enhancement on the dynamic contrast-enhanced CT scan may suggest a diagnosis of TL.

Keywords: Abdomen, Lymph node, Tuberculosis, Tomography, X-ray computed