Yuan Li, Presenter: Nothing to Disclose

Zhi-gang Yang MD, PhD, Abstract Co-Author: Nothing to Disclose

Ying-Kun Guo, Abstract Co-Author: Nothing to Disclose

Peng-Qiu Min, Abstract Co-Author: Nothing to Disclose

Jian-Gun Yu, Abstract Co-Author: Nothing to Disclose

En-sen Ma, Abstract Co-Author: Nothing to Disclose

Tuberculosis in abdominal lymph nodes is common in the developing countries and may be difficult to be distinguished from lymphoma. This study was to determine specific imaging criteria for differentiating tuberculosis from lymphoma in abdominal lymph nodes on the contrast-enhanced multi-detector row CT.

The contrast-enhanced multi-detector row CT features in 52 patients with tuberculosis (n = 20) and lymphoma (n = 32) in abdominal lymph nodes were retrospectively assessed for the morphology, density, enhancement pattern and location.

Ninety-five percent (19/20) of the tuberculosis showed peripheral enhancement, while only 19% (6/32) of lymphoma showed peripheral enhancement (p<0.01). 70% (14/20) of the tuberculosis and 6% (2/32) of lymphoma had a mass of multilocular appearance (p<0.01). Homogeneous attenuation was more commonly observed in lymphoma (26/32, 81%) than in tuberculosis (1/20, 5%) (p<0.01). Tuberculosis and lymphoma often involved the lesser omental, mesenteric, anterior pararenal, and upper paraaortic lymph nodes. The lower paraaortic lymph nodes were involved more often in lymphoma (25/32, 78%) than in tuberculosis (4/20, 20%)(p<0.01). In the determination of tuberculosis, sensitivity (95%), specificity (81%) and accuracy (87%) were obtained with peripheral enhancement. The sensitivity (70%), specificity (94%) and accuracy (85%) were achieved with multilocular appearance. With the combination of homogeneous attenuation and lower paraaortic lymph nodes, the sensitivity (78%), specificity (95%), and accuracy (85%) were achieved to determine the diagnosis of lymphoma.

The specific morphologic features and anatomic distribution of lymphadenopathy shown on contrast-enhanced multi-detector row CT can be used to differentiate tuberculosis from lymphoma in the abdominal lymph nodes.

Li, Y, Yang, Z, Guo, Y, Min, P, Yu, J, Ma, E, Differentiation between Tuberculosis and Lymphoma in Abdominal Lymph Nodes: Evaluation with Contrast-enhanced Multi-Detector Row CT.  Radiological Society of North America 2005 Scientific Assembly and Annual Meeting, November 27 - December 2, 2005 ,Chicago IL. http://archive.rsna.org/2005/4406196.html