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La radiologia medica

, Volume 116, Issue 7, pp 1067–1075 | Cite as

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

  • C. VallsEmail author
  • S. Ruiz
  • L. Martinez
  • D. Leiva
  • J. Busquets
  • T. Serrano
  • J. Fabregat
Abdominal Radiology / Radiologia Addominale

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.

Keywords

Liver Hepatic transplantation CT Lymph nodes 

Linfoadenomegalie nell’addome superiore dopo trapianto di fegato: imaging e significato clinico

Riassunto

Obiettivo

Il trapianto ortotopico di fegato (OLT) è il trattamento di scelta per le patologie epatiche allo stadio avanzato. In seguito a OLT, si possono sviluppare una serie di malattie che si manifestano con la presenza linfoadenomegalie nell’addome superiore.

Materiali e metodi

Tra gennaio 1995 e settembre 2006, nel nostro Istituto sono state effettuate 715 OLT in 585 pazienti. In 19 di questi (2,6%), l’ecografia ha evidenziato la presenza di linfoadenomegalie nell’addome superiore ed è quindi stata effettuata una indagine con tomografia computerizzata (TC).

Risultati

Gli esami istologici hanno rivelato un disturbo linfoproliferativo post-trapianto (PTLD) in 6 pazienti (31,5%), una neoplasia epatica in 6 pazienti (31,5%), una tubercolosi sistemica disseminata in un caso (5,2%) ed una sarcoidosi in un altro caso (5,2%). In 5 pazienti (26%) l’esame istologico ha evidenziato un’iperplasia linfonodale reattiva non specifica.

Conclusioni

Il rilevamento di linfoadenomegalie nell’addome superiore dopo trapianto di fegato è poco frequente, ma un imaging accurato è necessario per diagnosticare e caratterizzare un’ampia varietà di patologie. Nella maggior parte dei casi le linfoadenomegalie si riveleranno correlate ad un disordine linfoproliferativo post-trapianto o ad una recidiva di malattia.

Parole chiave

Fegato Trapianto di fegato TC Linfonodi 

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Copyright information

© Springer-Verlag Italia 2011

Authors and Affiliations

  • C. Valls
    • 1
    Email author
  • S. Ruiz
    • 1
  • L. Martinez
    • 1
  • D. Leiva
    • 1
  • J. Busquets
    • 1
  • T. Serrano
    • 1
  • J. Fabregat
    • 1
  1. 1.Department of RadiologyHospital Universitari de BellvitgeL’Hospitalet, BarcelonaSpain

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