Mesenteric lymph nodes in children: what is normal?

Karmazyn, Boaz; Werner, Elizabeth; Rejaie, Babak; Applegate, Kimberly E.

doi:10.1007/s00247-005-1462-2

Cited by 90 publications

(54 citation statements)

References 7 publications

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“…All examinations were performed on a Logos Hi-Vision C machine (Hitachi Medical Systems, Tokyo, Japan) using a broadband convex transducer (frequency 3.5–5 mHz) for the first evaluation and then a microconvex transducer (frequency 4–8 mHz) for a detailed evaluation of the bowel, lymph nodes, and mesentery. The following ultrasound parameters were evaluated: bowel wall thickness (normal ≤2 mm),18 small bowel dilatation (normal <25 mm),19 free fluid within the peritoneal cavity, enlarged mesenteric lymph nodes (short axis >8 mm),20 enlarged vermiform appendix (diameter >6 mm), and mesenteric hypertrophy (presence of hyperechoic area around thickened bowel wall >5 mm) 21,22. All patients were examined in the morning after fasting for at least 6 hours with an empty or moderately replete bladder.…”

Section: Methodsmentioning

confidence: 99%

Gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus

Mantegazza

Maconi

Giacomet

et al. 2014

HIV

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BackgroundThe gastrointestinal tract is a primary target for human immunodeficiency virus (HIV). HIV infection causes a depletion of CD4+ T-lymphocytes in gut-associated lymphoid tissue and affects gastrointestinal mucosal integrity and permeability. The gastrointestinal tract has also been suggested as the main reservoir of HIV despite highly active antiretroviral therapy (HAART). We performed a prospective case-control study to assess gut involvement in HIV-infected patients, either naïve or on HAART, using noninvasive methods such as bowel ultrasound and fecal calprotectin.MethodsThirty HIV-infected children and youth underwent the following tests: CD4+ T-cell count and HIV viral load, fecal calprotectin, and bowel ultrasound, with the latter evaluating bowel wall thickness and mesenteric lymph nodes. Fecal calprotectin and bowel ultrasound were also assessed in 30 healthy controls matched for age and sex. Fecal calprotectin was measured using a quantitative immunochromatographic point-of-care test, and concentrations ranging from 0 to 200 μg/g were considered to be normal reference values in children.ResultsFecal calprotectin was normal in 29 HIV-infected patients and was not significantly different from controls (mean values 63.8±42.5 μg/g and 68.3±40.5 μg/g, respectively; P=0.419), and did not correlate with HIV viral load, CD4+ T-cell absolute count and percentage, or HAART treatment. No significant changes were found on bowel ultrasound except for enlarged mesenteric lymph nodes, which were observed in seven HIV-infected patients (23.3%) and two controls (6.6%). This finding was significantly correlated with high HIV viral load (P=0.001) and low CD4+ T-cell percentage (P=0.004).ConclusionHIV-infected children did not have significant biochemical or ultrasonographic signs of bowel inflammation. A few patients showed enlarged mesenteric lymph nodes, which correlated with uncontrolled HIV infection.

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Section: Methodsmentioning

confidence: 99%

Gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus

Mantegazza

Maconi

Giacomet

et al. 2014

HIV

View full text Add to dashboard Cite

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“…65 Because normal children have been shown to have lymphadenopathy up to 5 mm, the authors recommend noting only lymphadenopathy greater than 1 cm unless there is clear central necrosis on CT, calcification, or low signal intensity on T2-weighted MRI images.…”

Section: Lymphadenopathy: What Size Is Abnormal?mentioning

confidence: 99%

Advances in Imaging Chest Tuberculosis: Blurring of Differences Between Children and Adults

Andronikou

Vanhoenacker

Backer

2009

Clinics in Chest Medicine

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“…Several authors have studied the normal dimensions of abdominal lymph nodes at imaging studies of adult individuals in different clinical conditions, but few studies with children are found in the literature (3,5) . A criterion that is frequently utilized to define lymph node enlargement is the smallest diameter > 4 mm (measured by means of ultrasonography) or 5 mm (CT) (14)(15)(16)(17) . However, enlarged lymph nodes are found on imaging studies of asymptomatic patients, with these same values (14,(18)(19)(20) .…”

Section: Discussionmentioning

confidence: 99%

Local behavior and lymph node metastases of Wilms' tumor: accuracy of computed tomography

Silva

2014

Radiol Bras

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ResumoObjective: To evaluate the accuracy of computed tomography for local and lymph node staging of Wilms' tumor. Materials and Methods: Each case of Wilms' tumor was evaluated for the presence of abdominal lymph nodes by a radiologist. Signs of capsule and adjacent organ invasion were analyzed. Surgical and histopathological results were taken as the gold standard. Results: Sensitivity was 100% for both mesenteric and retroperitoneal lymph nodes detection, and specificity was, respectively, 12% and 33%, with positive predictive value of 8% and 11% and negative predictive value of 100%. Signs of capsular invasion presented sensitivity of 87%, specificity of 77%, positive predictive value of 63% and negative predictive value of 93%. Signs of adjacent organ invasion presented sensitivity of 100%, specificity of 78%, positive predictive value of 37% and negative predictive value of 100%. Conclusion: Computed tomography tumor showed low specificity and low positive predictive value in the detection of lymph node dissemination. The absence of detectable lymph nodes makes their presence unlikely, and likewise regarding the evaluation of local behavior of tumors.Keywords: Computed tomography; Wilms' tumor; Staging.Objetivo: Avaliar a acurácia da tomografia computadorizada no estadiamento local e linfonodal de pacientes com tumor de Wilms. Materiais e Métodos: Um radiologista avaliou a presença de linfonodos abdominais em cada caso. Sinais de invasão capsular e de órgão adjacente foram analisados. Resultados cirúrgicos e histopatológicos foram tomados como padrão ouro. Resultados: A sensibilidade da detecção de linfonodos mesentéricos e retroperitoneais foi 100% (ambos) e a especificidade foi 12% e 33%, respectivamente, com valores preditivos positivos de 8% e 11% e negativos de 100% (ambos). Sinais de invasão capsular apresentaram sensibilidade de 87%, especificidade de 77% e valores preditivos positivo de 63% e negativo de 93%. Invasão de órgão adjacente foi diagnosticada com sensibilidade de 100%, especificidade de 78% e valores preditivos positivo de 37% e negativo de 100%. Conclusão: A tomografia computadorizada mostrou baixa especificidade e valor preditivo positivo na detecção de disseminação linfonodal. Ausência de linfonodos detectáveis tornou a disseminação improvável, assim como sinais de invasão local.

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Mesenteric lymph nodes in children: what is normal?

Cited by 90 publications

References 7 publications

Gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus

Gut and mesenteric lymph node involvement in pediatric patients infected with human immunodeficiency virus

Advances in Imaging Chest Tuberculosis: Blurring of Differences Between Children and Adults

Local behavior and lymph node metastases of Wilms' tumor: accuracy of computed tomography

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