ENLARGED ABDOMINAL LYMPH-NODES IN END-STAGE CIRRHOSIS - CT-HISTOPATHOLOGIC CORRELATION IN 507 PATIENTS

PURPOSE: To determine the frequency, distribution, size, and cause of enlarged abdominal lymph nodes in patients with end-stage cirrhosis. M ATERIALS AND METHODS: Preoperative computed tomographic (CT) scans fro m 507 hepatic transplantation patients with end-stage cirrhosis were r eviewed for the presence, size, and location of enlarged (short-axis d iameter > 1 cm) abdominal lymph nodes. Enlarged lymph nodes were ident ified and resected at surgery. Resected livers were evaluated for mali gnant neoplasms. CT findings were correlated with histopathologic resu lts. RESULTS: Enlarged abdominal lymph nodes were detected with CT in 253 (50%) of the patients. The enlarged nodes were 1.1 x 1.1 to 3.0 x 4.5 cm in size and were most common in the portacaval space and porta hepatis. The frequency of enlarged nodes varied according to type of c irrhosis: They were most common in patients with primary biliary cirrh osis (86% [43 of 50]) and least common in patients with alcohol-induce d cirrhosis (37% [42 of 113]). Histologic evaluation revealed that the enlarged lymph nodes were due to benign nodal hyperplasia in 251 pati ents and malignant neoplasm in two patients. CONCLUSION: Enlarged abdo minal lymph nodes are common in patients with all forms of end-stage c irrhosis. In the absence of other evidence of malignancy, enlarged nod es in these patients should be considered a benign process, with no ad ditional evaluation warranted.