66 Mesenteric Lymph Node Enlargement

CLINICAL IMAGAGINGAN ATLAS OF DIFFERENTIAL DAIGNOSIS

EISENBERG

DR. Muhammad Bin Zulfiqar PGR-FCPS III SIMS/SHL

• Fig GI 66-1 Lymphoma. (A) Homogeneous conglomerate mass formed by coalescent mesenteric and retroperitoneal adenopathy. The mass surrounds but does not occlude the mesenteric vessels (arrows). (B) On this image, the mass displaces bowel loops but does not occlude them (arrows).84

• Fig GI 66-2 Lymphoma. (A) There is increased attenuation of the mesentery (“misty mesentery”; white arrow) and soft-tissue nodules (black arrows) along the superior mesenteric vessels. Note the subcentimeter retroperitoneal lymph nodes (arrowheads). (B) The misty mesentery (white arrows) and soft-tissue nodules (black arrows) are seen again. The fat (white arrowheads) immediately adjacent to mesenteric vessels along their long axes is preserved. Note the retroperitoneal lymph nodes (black arrowheads). (C) Prominent nodules (arrows) surround mesenteric vessels. There is soft-tissue stranding (arrowheads) anterior to the inferior vena cava and aorta.85

• Fig GI 66-3 Metastases (from gastric carcinoma). Small mesenteric lymph nodes (arrows) associated with a concentrically thickened gastric antrum.84

• Fig GI 66-4 Metastases (from colon carcinoma). Mesenteric lymphadenopathy (arrows), which is easily seen against the intra-abdominal fat.84

• Fig GI 66-5 Leukemia. Extensive bulky lymphadenopathy both at the mesenteric root and throughout the periphery of the mesentery (arrows).84

• Fig GI 66-6 Kaposi's sarcoma. Homogeneous soft-tissue mass formed by mesenteric lymphadenopathy (top arrow). The mass surrounds the mesenteric vessels (bottom arrows) but does not occlude them.84

Fig GI 66-7 Appendicitis. Multiple lymph nodes in the mesentery of the right lower quadrant (arrowheads).84

• Fig GI 66-8 Crohn's disease. Lmphadenopathy throughout the periphery of the mesentery (arrow) and in the mesentery of the right lower quadrant.84

• Fig GI 66-9 Mesenteric panniculitis. Multiple enlarged nodes in the mesentery (arrows). Note the inflammatory changes in the surrounding mesentery (arrowhead).84

• Fig GI 66-10 Systemic lupus erythematosus. Multiple enlarged lymph nodes throughout the mesentery (arrows).84

• Fig GI 66-11 Amyloidosis. Diffuse mesenteric lymphadenopathy (arrows).

• Fig GI 66-12 Mesenteric adenitis. Innumerable lymph nodes in the mesentery of the right lower quadrant (arrows in A) and at the mesenteric root (arrows in B).84

• Fig GI 66-13 Mycobacterium avium complex (MAC) infection in HIV. Extensive mesenteric lymphadenopathy of uniform soft-tissue attenuation (arrows). The lymph nodes are discrete with no formation of a conglomerate mass or displacement of vessels or intestines.84

• Fig GI 66-14 Cavitating mesenteric lymph node syndrome. Enlarged mesenteric lymph nodes with characteristic fat-fluid levels (arrowheads). (Case courtesy of Denise Reddy, Loyola University Medical Center, Maywood, IL).86