Kj. Johnson et al., The presence and significance of lymphadenopathy detected by CT in primarysclerosing cholangitis, BR J RADIOL, 71(852), 1998, pp. 1279-1282
Citations number
17
Categorie Soggetti
Radiology ,Nuclear Medicine & Imaging","Medical Research Diagnosis & Treatment
Patients with primary sclerosing cholangitis (PSC) are at increased risk of
developing cholangiocarcinoma, which adversely affects their survival, esp
ecially after orthotopic liver transplantation. All CT scans of patients wi
th PSC referred to the Liver Unit at the Queen Elizabeth Hospital since 199
2 were reviewed. The location of any lymph node with a short axis diameter
greater than normal was documented. The incidence of lymphadenopathy and ch
olangiocarcinoma was also documented. 36 scans are reviewed, including eigh
t with cholangiocarcinoma as well as PSC. Abdominal lymphadenopathy was pre
sent in 26 cases (66%) and 45 separate lymph node groups were involved in t
hese patients. There were eight cases of cholangiocarcinoma; five were dete
ctable on CT, but only four had significant lymphadenopathy. The remaining
three cases of cholangiocarcinoma were not detectable on CT and only one of
these had lymphadenopathy. Follow-up of the remaining patients has not dem
onstrated the development of cholangiocarcinoma. Lymphadenopathy is commonl
y demonstrated by CT in PSC patients, but does not imply malignancy and sho
uld not exclude a patient from undergoing liver transplantation. Conversely
cholangiocarcinoma may develop without significant lymphadenopathy.