Retrospective cohort study of portacaval lymphadenopathy identified on multidetector CT and implications for follow-up

Veena Iyer, Sandeep S. Hedgire, Sumedh S. Hoskote, David Borczuk, Mukesh G. Harisinghani

Research output: Contribution to journalArticle

Abstract

Purpose: Portacaval lymphadenopathy (PCLA) is common in cirrhosis and chronic viral hepatitis and is frequently an incidental finding on abdominal CT scans. We aimed to detect the incidence of malignancy in organs drained by portacaval nodes in patients with PCLA associated with cirrhosis or chronic viral hepatitis, or incidentally detected PCLA. Methods: We searched CT reports from 2005 to 2007 for the phrases “periportal node” and “portacaval node.” MDCTs of patients with portacaval nodes ≥10 mm in maximal short-axis size on contrast-enhanced MDCTs, were included. Records were reviewed for presence of malignancy, liver metastases, chronic viral hepatitis, and cirrhosis. Clinical or imaging follow-up ≥6 months was performed to detect if malignancy developed in organs drained by portacaval nodes in patients with incidental PCLA, cirrhosis, or chronic viral hepatitis. Results: 479 patients met inclusion criteria [298 males (62%), mean age 61.4 years]. In 285 (59.5%) patients, PCLA was explained by local pathology or systemic lymphadenopathy. PCLA was incidental in 146 (30.5%) patients. Of these, 112 (76.7%) had ≥6 months of follow-up (median 26 months). No patient with incidental PCLA developed malignancy in organs drained by these nodes. Cirrhosis or chronic viral hepatitis was present in 48 (10.0%) patients. Of these, 42 (87.5%) had ≥6 months follow-up (median 28 months), and only 1 patient developed cholangiocarcinoma (positive predictive value 2.4%). Conclusions: Development of malignancy is rare in patients with PCLA, either incidental or secondary to cirrhosis or chronic viral hepatitis. Our study suggests that no follow-up of PCLA is required in these settings.

Original languageEnglish (US)
Pages (from-to)1481-1486
Number of pages6
JournalAbdominal Imaging
Volume40
Issue number6
DOIs
StatePublished - Aug 12 2015
Externally publishedYes

Fingerprint

Cohort Studies
Retrospective Studies
Chronic Hepatitis
Fibrosis
Neoplasms
Lymphadenopathy
Incidental Findings
Cholangiocarcinoma
Pathology
Neoplasm Metastasis
Liver
Incidence

Keywords

  • Cirrhosis
  • Incidental lymphadenopathy
  • Portacaval lymph nodes
  • Viral hepatitis

ASJC Scopus subject areas

  • Radiological and Ultrasound Technology
  • Radiology Nuclear Medicine and imaging
  • Gastroenterology
  • Urology

Cite this

Retrospective cohort study of portacaval lymphadenopathy identified on multidetector CT and implications for follow-up. / Iyer, Veena; Hedgire, Sandeep S.; Hoskote, Sumedh S.; Borczuk, David; Harisinghani, Mukesh G.

In: Abdominal Imaging, Vol. 40, No. 6, 12.08.2015, p. 1481-1486.

Research output: Contribution to journalArticle

Iyer, Veena ; Hedgire, Sandeep S. ; Hoskote, Sumedh S. ; Borczuk, David ; Harisinghani, Mukesh G. / Retrospective cohort study of portacaval lymphadenopathy identified on multidetector CT and implications for follow-up. In: Abdominal Imaging. 2015 ; Vol. 40, No. 6. pp. 1481-1486.
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abstract = "Purpose: Portacaval lymphadenopathy (PCLA) is common in cirrhosis and chronic viral hepatitis and is frequently an incidental finding on abdominal CT scans. We aimed to detect the incidence of malignancy in organs drained by portacaval nodes in patients with PCLA associated with cirrhosis or chronic viral hepatitis, or incidentally detected PCLA. Methods: We searched CT reports from 2005 to 2007 for the phrases “periportal node” and “portacaval node.” MDCTs of patients with portacaval nodes ≥10 mm in maximal short-axis size on contrast-enhanced MDCTs, were included. Records were reviewed for presence of malignancy, liver metastases, chronic viral hepatitis, and cirrhosis. Clinical or imaging follow-up ≥6 months was performed to detect if malignancy developed in organs drained by portacaval nodes in patients with incidental PCLA, cirrhosis, or chronic viral hepatitis. Results: 479 patients met inclusion criteria [298 males (62{\%}), mean age 61.4 years]. In 285 (59.5{\%}) patients, PCLA was explained by local pathology or systemic lymphadenopathy. PCLA was incidental in 146 (30.5{\%}) patients. Of these, 112 (76.7{\%}) had ≥6 months of follow-up (median 26 months). No patient with incidental PCLA developed malignancy in organs drained by these nodes. Cirrhosis or chronic viral hepatitis was present in 48 (10.0{\%}) patients. Of these, 42 (87.5{\%}) had ≥6 months follow-up (median 28 months), and only 1 patient developed cholangiocarcinoma (positive predictive value 2.4{\%}). Conclusions: Development of malignancy is rare in patients with PCLA, either incidental or secondary to cirrhosis or chronic viral hepatitis. Our study suggests that no follow-up of PCLA is required in these settings.",
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T1 - Retrospective cohort study of portacaval lymphadenopathy identified on multidetector CT and implications for follow-up

AU - Iyer, Veena

AU - Hedgire, Sandeep S.

AU - Hoskote, Sumedh S.

AU - Borczuk, David

AU - Harisinghani, Mukesh G.

PY - 2015/8/12

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N2 - Purpose: Portacaval lymphadenopathy (PCLA) is common in cirrhosis and chronic viral hepatitis and is frequently an incidental finding on abdominal CT scans. We aimed to detect the incidence of malignancy in organs drained by portacaval nodes in patients with PCLA associated with cirrhosis or chronic viral hepatitis, or incidentally detected PCLA. Methods: We searched CT reports from 2005 to 2007 for the phrases “periportal node” and “portacaval node.” MDCTs of patients with portacaval nodes ≥10 mm in maximal short-axis size on contrast-enhanced MDCTs, were included. Records were reviewed for presence of malignancy, liver metastases, chronic viral hepatitis, and cirrhosis. Clinical or imaging follow-up ≥6 months was performed to detect if malignancy developed in organs drained by portacaval nodes in patients with incidental PCLA, cirrhosis, or chronic viral hepatitis. Results: 479 patients met inclusion criteria [298 males (62%), mean age 61.4 years]. In 285 (59.5%) patients, PCLA was explained by local pathology or systemic lymphadenopathy. PCLA was incidental in 146 (30.5%) patients. Of these, 112 (76.7%) had ≥6 months of follow-up (median 26 months). No patient with incidental PCLA developed malignancy in organs drained by these nodes. Cirrhosis or chronic viral hepatitis was present in 48 (10.0%) patients. Of these, 42 (87.5%) had ≥6 months follow-up (median 28 months), and only 1 patient developed cholangiocarcinoma (positive predictive value 2.4%). Conclusions: Development of malignancy is rare in patients with PCLA, either incidental or secondary to cirrhosis or chronic viral hepatitis. Our study suggests that no follow-up of PCLA is required in these settings.

AB - Purpose: Portacaval lymphadenopathy (PCLA) is common in cirrhosis and chronic viral hepatitis and is frequently an incidental finding on abdominal CT scans. We aimed to detect the incidence of malignancy in organs drained by portacaval nodes in patients with PCLA associated with cirrhosis or chronic viral hepatitis, or incidentally detected PCLA. Methods: We searched CT reports from 2005 to 2007 for the phrases “periportal node” and “portacaval node.” MDCTs of patients with portacaval nodes ≥10 mm in maximal short-axis size on contrast-enhanced MDCTs, were included. Records were reviewed for presence of malignancy, liver metastases, chronic viral hepatitis, and cirrhosis. Clinical or imaging follow-up ≥6 months was performed to detect if malignancy developed in organs drained by portacaval nodes in patients with incidental PCLA, cirrhosis, or chronic viral hepatitis. Results: 479 patients met inclusion criteria [298 males (62%), mean age 61.4 years]. In 285 (59.5%) patients, PCLA was explained by local pathology or systemic lymphadenopathy. PCLA was incidental in 146 (30.5%) patients. Of these, 112 (76.7%) had ≥6 months of follow-up (median 26 months). No patient with incidental PCLA developed malignancy in organs drained by these nodes. Cirrhosis or chronic viral hepatitis was present in 48 (10.0%) patients. Of these, 42 (87.5%) had ≥6 months follow-up (median 28 months), and only 1 patient developed cholangiocarcinoma (positive predictive value 2.4%). Conclusions: Development of malignancy is rare in patients with PCLA, either incidental or secondary to cirrhosis or chronic viral hepatitis. Our study suggests that no follow-up of PCLA is required in these settings.

KW - Cirrhosis

KW - Incidental lymphadenopathy

KW - Portacaval lymph nodes

KW - Viral hepatitis

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