Clinical Relevance of Perihepatic Lymphadenopathy in Acute and Chronic Liver Disease

Abstract

Perihepatic lymphadenopathy is found in infectious and autoimmune liver diseases, but not in metabolic or toxic liver damage. The absence of perihepatic lymph nodes in acute liver failure should lead to intensive search for a toxic or metabolic cause.

Prevalence of Sonographic Signs in Children with Acute Hepatitis in Zahedan City, Southeast of Iran

“…In a study conducted by Braden et al (15), it was concluded that periportal lymphadenopathy is common in infectious diseases and acute autoimmune diseases, and the absence of periportal lymph nodes in acute liver injury has led to a search for toxic and metabolic causes.…”

“…To determine the prevalence of sonographic signs in patients with viral and acute hepatitis, ultrasound and computerized tomography scan (CT scan) studies have been investigated by some researchers (2,(13)(14)(15). Also, some other researchers have studied the efficacy of conventional ultrasound and Doppler in the diagnosis of acute hepatitis (16).…”

“…Ultrasound symptoms reported in children with acute hepatitis include: Hepatomegaly, increased liver echogenicity, increased echogenicity of portal vein walls, and increased the gallbladder wall thickness. These symptoms are not specific to acute hepatitis by themselves, but their presence suggests acute hepatitis (13)(14)(15). The ultrasound symptoms of acute hepatitis in pediatrics include hepatomegaly, periportal lymphadenopathy, splenomegaly, increased thickness of the gallbladder wall, decreased or increased echogenicity of the liver and increased echogenicity of the portal walls (2), but there is no consensus on the prevalence or the importance of the mentioned findings among researches (18).…”

S2k Leitlinie Autoimmune Lebererkrankungen

“…B. eine intra-oder extrahepatische Gallenwegerweiterung, Tumoren oder Gefäßthrombosen) auszuschließen [133]. Abdominelle Lymphknoten sind in 40 -90 % der Patienten mit AIH darzustellen [134,135]. Es gibt jedoch keine AIH-spezifischen Ultraschallkennzeichen.…”

“…Zum Ausschluss obstruierender Gallenwegerkrankungen in der Initialdiagnostik soll ein abdomineller Ultraschall erfolgen [133]. Abdominelle Lymphknoten(vergrößerungen) bei Patienten mit PBC sind in 87 -97 % zu sehen [134,135], es gibt jedoch keine PBC-spezifischen Ultraschallkennzeichen. Die diagnostischen Genauigkeiten zur Detektion einer Zirrhose mittels B-Bild-Ultraschall liegen bei 78 bis 88 % und können durch Kombination mit der Scherwellenelastografie verbessert werden [136,137].…”