Abstract
Purpose
To clarify features of lymph nodes associated with leukemia purposing to offer help for imaging diagnosis and differential diagnosis of leukemia.
Materials and Methods
We retrospectively analyzed 47 patients with clinically proven leukemia involving the abdominal and pelvic lymph nodes. Of these 47 patients, 10 had acute myeloid leukemia, 9 had acute lymphocytic leukemia, and 28 had chronic lymphocytic leukemia. MDCT was used to determine lymph node features such as morphology, growth patterns, size, enhancement patterns, anatomical distribution, and manifestations in extramedullary organs.
Results
Incidence of leukemia was higher in men than in women. Enlarged lymph nodes were more frequently conglomerated in chronic lymphocytic leukemia (96.4%) than in acute myeloid leukemia (50%) and acute lymphocytic leukemia (55.6%; P < 0.05 for both). Lymph nodes associated with chronic lymphocytic leukemia were larger than those associated with acute myeloid and lymphocytic leukemias (P < 0.05 for both). The enlarged lymph nodes appeared homogeneous (80.9%) and homogeneous mixed with peripheral (19.1%). No statistically significant differences were observed between the three types of leukemias with respect to enhancement patterns (all P > 0.05). The lymph nodes commonly associated with these three leukemias were located in the lesser omentum, upper and lower para-aortic regions, and groin region.
Conclusions
Our study showed that contrast-enhanced MDCT could accurately determine the enhancement patterns and anatomical distribution of lymph nodes associated with leukemia. Therefore, it is helpful for imaging diagnosis and differential diagnosis of leukemia.
Similar content being viewed by others
References
Cotran RS, Kumar V, Robbins SL (1994) Diseases of white cells, lymph nodes and spleen. In: Cortran RS, Kumar V, Robbins SL (eds) Robbins pathologic basis of disease. Philadelphia: W.B. Saunders Company, pp 629–672
Howlader N, Noone AM, Krapcho M, et al. (2014) SEER cancer statistics review, 1975–2011. National Cancer Institute, Bethesda. http://seer.cancer.gov/csr/1975_2011/. Accessed 20 April 2014
Inamdar KV, Bueso-Ramos CE (2007) Pathology of chronic lymphocytic leukemia: an update. Ann Diagn Pathol 11(5):363–389
Han X, Bueso-Ramos CE (2005) Advances in the pathological diagnosis and biology of acute lymphoblastic leukemia. Ann Diagn Pathol 9(4):239–257
Shao H, Yang Z-g, Deng W, et al. (2012) Tuberculosis versus lymphoma in the abdominal lymph nodes: a comparative study using contrast-enhanced MRI. Eur J Radiol 81(10):2513–2517
Lo WC, Chang WC, Lin YC, et al. (2012) Ultrasonographic differentiation between Kikuchi’s disease and lymphoma in patients with cervical lymphadenopathy. Eur J Radiol 81(8):1817–1820
Thoeny HC, Triantafyllou M, Birkhaeuser FD, et al. (2009) Combined ultrasmall superparamagnetic particles of iron oxide-enhanced and diffusion-weighted magnetic resonance imaging reliably detect pelvic lymph node metastases in normal-sized nodes of bladder and prostate cancer patients. Eur Urol 55(4):761–769
Dorfman RE, Alpern MB, Gross BH, et al. (1991) Upper abdominal lymph nodes: criteria for normal size determined with CT. Radiology 180(2):319–322
Gollard RP, Robbins BA, Piro L, et al. (1996) Acute myelogenous leukemia presenting with bulky lymphadenopathy. Case report and literature review. Acta Haematol 95(2):129–134
Yang ZG, Min PQ, Sone S, et al. (1999) Tuberculosis versus lymphomas in the abdominal lymph nodes: evaluation with contrast-enhanced CT. AJR 172(3):619–623
Paul Guillerman P, Voss SD, Parker BR (2011) Leukemia and lymphoma. Radiol Clin N Am 49(4):767–797
Matutes E, Attygalle A, Wotherspoon A, et al. (2010) Diagnostic issues in chronic lymphocytic leukaemia (CLL). Best Pract Res Clin Haematol 23(1):3–20
Walz Mattmuller R, Horny HP, Ruck P, et al. (1998) Incidence and pattern of liver involvement in haematological malignancies. Pathol Res Prac 194:781–789
Lampert IA, Wotherspoon A, Noorden SV, et al. (1999) High expression of CD23 in the proliferation centers of chronic lymphocytic leukemia in lymph nodes and spleen. Human Pathology 30(6):648–654
Takazoe K, Abe A, Kawamura T, et al. (1996) Persistent renal failure in acute myelomonocytic leukemia. Nephron 73:728–729
Griffith RC, Janney CG (1990) Lymph nodes. In: Kissance JM (ed) Anderson’s pathology, 9th edn. St. Louis: Mosby, pp 1429–1492
Kim SH, Cho OH, Park SJ, et al. (2009) Diagnosis of abdominal tuberculosis by T-cell-based assays on peripheral blood and peritoneal fluid mononuclear cells. J Infect 59(6):409–415
Katyal S, Oliver JH 3, Perterson MS, et al. (2000) Extrahepatic metastases of hepatocellular carcinoma. Radiology 216(3):698–703
Yi Y, Yu J, Li B, et al. (2010) Pattern of lymph node metastases and its implication in radiotherapeutic clinical target volume delineation of regional lymph node in patients with gastric carcinoma. Radiother Oncol 96(2):223–230
Assouad J, Riquet M, Foucault C, et al. (2006) Renal lymphatic drainage and thoracic duct connections: implications for cancer spread. Lymphology 39:26–32
Vardiman JW (2010) The World Health Organization (WHO) classification of tumors of the hematopoietic and lymphoid tissues: an overview with emphasis on the myeloid neoplasms. Chem Biol Interact 184(1–2):16–20
Acknowledgments
The study was supported by the Committee of the National Natural Science Foundation of China (30876088).
Conflict of interest
The authors declare no conflict of interest.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Zhang, G., Yang, Zg., Bai, J. et al. Leukemias involving abdominal and pelvic lymph nodes: evaluation with contrast-enhanced MDCT. Abdom Imaging 39, 1063–1069 (2014). https://doi.org/10.1007/s00261-014-0128-7
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00261-014-0128-7