Generalized lymphadenopathy, which involves two or more non-contiguous regions, is reported to occur in 25% of lymphadenopathies. About 75% of most lymphadenopathies are localized, and about 50% of those occur in the head and neck regions. Lymphadenopathy can be localized or diffuse. Lymphoproliferative disorders such as hemophagocytic lymphohistiocytosis can also manifest with the enlargement of lymph nodes. ![]() ![]() Malignant diseases like lymphoma, leukemia, metastatic cancer, and head and neck cancers are also common causes of lymphadenopathy. Autoimmune disorders that may contribute include but are not limited to sarcoidosis, amyloidosis, systemic lupus erythematosus, rheumatoid arthritis, and eosinophilic granulomatosis with polyangiitis. There is a wide range of infectious etiologies, including bacterial, fungal, viral, mycobacterial, spirochetal, and protozoal organisms. There are several potential causes of lymphadenopathy, ranging from infectious, autoimmune, malignant, and lymphoproliferative. Lymphadenopathy, while pertinent, may be nonspecific. In general, the size of a normal lymph node in the adult population should be less than 1 cm however, there are exceptions to this rule. When inspecting for lymphadenopathy, one should carefully examine all pertinent anatomic regions, including the neck, supraclavicular, axillary, and inguinal regions. They are divided into sections known as follicles, which are subdivided into B zones and T zones, which represent the base location of lymphocytic maturation.Ībnormal proliferation of lymphocytes may be a result of inflammation, infection, or malignancy, and thus, clinicians must perform a detailed history and physical to screen for lymphadenopathy. Lymph nodes are small glands that are responsible for filtering fluid from the lymphatic system. Lymphadenopathy is a term that refers to the swelling of lymph nodes. Lymphocytes are the integral agents involved in searching for target proteins and travel through lymph nodes, which are diffusely placed throughout the body. Such nodes when found in an otherwise healthy population are clinically insignificant and require no further imaging.The lymphatic system is a complex component of the immune system involved in filtering substances in the body. In general, these nodes are small, measuring less than 5 mm. Incidental finding of mesenteric lymph nodes is common, reflecting more widespread use of thin-collimation MDCT and PACS workstations. Nodes were identified in more than one location in two patients (4%). These nodes were identified only at the mesenteric root in 32 patients (68%), only in the mesenteric periphery in eight patients (17%), and only in the right lower quadrant in five patients (11%). The mean size of the largest nodes was 4.8 mm (range, 3-9 mm), and the mean size of the nodes found per patient was 3.6 mm (range, 3-6 mm). Twenty-five (53%) of the 47 patients had four or fewer nodes. Of these 47 patients, 22 (47%) had five or more lymph nodes detected. Of the 120 patients with otherwise normal CT scans, 47 had mesenteric lymph nodes greater than 3 mm. All studies were reviewed on a PACS workstation. Lymph node size, number, and location (central, peripheral, or right lower quadrant) were documented. Two radiologists evaluated the images by consensus and recorded the presence of mesenteric lymph nodes greater than 3 mm in the short axis. ![]() All imaging was performed using 3.2-mm collimation on MDCT scanners with IV contrast material. Twelve patients were excluded because they had disease processes known to be associated with lymphadenopathy. We examined the CT scans of 132 consecutive patients (84 men and 36 women age range, 12-90 years mean age, 43 years) who presented to the emergency department after experiencing blunt abdominal trauma. The purpose of this study is to document the incidence of mesenteric lymph nodes in a previously healthy population and to provide guidelines for further management. What to do with these findings has not been well established. Unsuspected mesenteric lymph nodes are frequently found on abdominal CT scans in everyday clinical practice.
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