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 language | English (US) |
|---|---|
| Pages (from-to) | 1481-1486 |
| Number of pages | 6 |
| Journal | Abdominal Imaging |
| Volume | 40 |
| Issue number | 6 |
| DOIs | |
| State | Published - Aug 12 2015 |
| Externally published | Yes |
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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 journal › Article
}
TY - JOUR
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
Y1 - 2015/8/12
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
UR - http://www.scopus.com/inward/record.url?scp=84938899664&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84938899664&partnerID=8YFLogxK
U2 - 10.1007/s00261-014-0328-1
DO - 10.1007/s00261-014-0328-1
M3 - Article
C2 - 25516214
AN - SCOPUS:84938899664
VL - 40
SP - 1481
EP - 1486
JO - Abdominal Radiology
JF - Abdominal Radiology
SN - 2366-004X
IS - 6
ER -