Abdominal lymphadenopathy: spectrum of CT findings

Many malignant processes cause abdominal lymphadenopathy, and computed tomography (CT) has become the primary modality for its detection. Diagnosis of lymphadenopathy is facilitated by optimal imaging techniques and a knowledge of the various nodal chains, their complex interconnections, and preferential pathways of spread. Optimal techniques include imaging after oral administration of adequate amounts of barium suspension and dynamic scanning after intravenous administration of contrast material with an infusion pump. Although such techniques help prevent misdiagnoses due to normal and anomalous vascular structures, other benign diseases can mimic the CT appearance of malignant lymphadenopathy. The authors emphasize a regional approach for the diagnosis of lymphadenopathy, according to the groupings of retrocrural, retroperitoneal, gastrohepatic ligament, porta hepatis, celiac and superior mesenteric artery, pancreaticoduodenal, perisplenic, mesenteric, and pelvic lymph nodes. Lymphadenopathy is defined as retrocrural nodes greater than 6 mm in short axis, upper abdominal nodes greater than 10 mm, and pelvic nodes greater than 15 mm.