Enlarged lymph nodes in the upper abdomen after liver transplantation: imaging features and clinical significance

Radiol Med. 2011 Oct;116(7):1067-75. doi: 10.1007/s11547-011-0690-9. Epub 2011 Jun 4.

Abstract

Purpose: Our aim was to review our single-centre experience regarding imaging features and pathological conditions arising from enlarged lymph nodes following orthotopic liver transplantation (OLD) and identify imaging features that may allow narrowing the differential diagnosis.

Materials and methods: Between January 1997 and September 2008, 715 OLTs were performed at our Institution in 585 patients. In 19 patients (2.6 %) ultrasound (US) showed enlarged lymph nodes in the upper abdomen, and abdominal computed tomography (CT) was performed

Results: Histological results showed posttransplantation lymphoproliferative disorder (PTLD) in six patients (31.5 %), hepatic tumoral disease in six (31.5 %), disseminated systemic tuberculosis in one (5.2%) and sarcoidosis in one (5.2%). Histological results showed nonspecific reactive lymph node hyperplasia in five patients (26%).

Conclusions: Detecting enlarged lymph nodes in the upper abdomen after liver transplantation is and infrequent occurrence; however, thorough imaging is required to detect and characterise a wide variety of disorders. Most of the time, enlarged lymph nodes will be related to posttransplantation lymphoproliferative disorder or tumoral recurrence.

MeSH terms

  • Abdomen
  • Adolescent
  • Adult
  • Aged
  • Diagnosis, Differential
  • Female
  • Follow-Up Studies
  • Humans
  • Immunosuppression Therapy / adverse effects
  • Liver Neoplasms / diagnosis*
  • Liver Neoplasms / etiology
  • Liver Transplantation / adverse effects*
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology*
  • Lymphoproliferative Disorders / diagnosis*
  • Lymphoproliferative Disorders / etiology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Sarcoidosis / diagnosis
  • Sarcoidosis / etiology
  • Tomography, X-Ray Computed
  • Tuberculosis, Miliary / diagnosis*
  • Tuberculosis, Miliary / etiology
  • Ultrasonography