Normal and enlarged perihepatic and mediastinal lymph nodes are detectable
by ultrasonography. Aim of the present study is to determine the detection
rate. size, and correlation of mediastinal and perihepatic lymphadenopathy
in patients with chronic hepatitis C, healthy controls, and patients with i
nflammatory or neoplastic mediastinal lymphadenopathy. The mediastinum and
liver hilus of 89 patients with chronic hepatitis C as well as as 34 health
y volunteers and 20 patients with mediastinal lymphadenopathy of different
origin with adequate sonographic visualization were screened for the number
and size of lymph nodes by high resolution ultrasonography. Lymph nodes we
re detectable in the mediastinum of 75/89 (84%) patients with chronic hepat
itis C and 22/34 (65%) healthy volunteers (total lymph node volume [LNV]: 1
.0 +/- 0.8 mL, versus 0.3 +/- 0.4 mL, p < 0.01). In all patients with media
stinal lymphadenopathy, the mediastinal lymph node volume was above 15 mL.
In patients with chronic hepatitis C a trend could be observed, that patien
ts with larger perihepatic lymph nodes reveal also larger mediastinal lymph
nodes. High resolution ultrasonography is able to detect enlarged mediasti
nal lymph nodes in patients with chronic hepatitis C. Mediastinal lymphaden
opathy is considered as an extrahepatic manifestation of chronic hepatitis
C. In general, the mediastinal lymph node volume differs in size to patient
s with lymphadenopathy related to neoplasia or sarcoidosis. The mechanism o
f lympadenopathy in the liver hilus and mediastinum in patients with chroni
c hepatitis C is vet unknown.