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Increased through-transmission in abdominal tuberculous lymphadenitis
Shaya Ghazinoor1, Terry Desser, R Brooke Jeffrey
1Stanford Hospital and Clinics, 300 Pasteur Dr, Stanford, CA 94305-5621, USA.
Summary
Abdominal tuberculosis can be diagnosed using ultrasound (sonography) to identify characteristic changes in mesenteric lymph nodes, specifically increased through-transmission suggesting caseating necrosis.
Area of Science:
- Radiology
- Infectious Diseases
- Gastroenterology
Background:
- Abdominal tuberculosis presents with varied symptoms, making diagnosis challenging.
- Mesenteric lymphadenopathy is a common finding in abdominal tuberculosis.
Observation:
- Sonography revealed hypoechoic lesions with increased through-transmission in mesenteric lymph nodes.
- Harmonic imaging enhanced the visualization of posterior acoustic enhancement in necrotic lymph nodes.
- Absence of color flow in lesions differentiated tuberculous lymphadenitis from other causes.
Findings:
- Ultrasound findings of increased through-transmission and posterior acoustic enhancement are suggestive of tuberculous lymphadenitis.
- Sonographically guided fine-needle aspiration provided a definitive diagnosis of tuberculosis.
- Correlation with CT and colonoscopy findings supported the sonographic diagnosis.
Implications:
- Sonography, particularly with harmonic imaging, is a valuable tool for diagnosing abdominal tuberculosis.
- This imaging modality facilitates targeted biopsies for definitive diagnosis.
- Early detection through sonography can improve patient outcomes for abdominal tuberculosis.