P434 PAY ATTENTION TO PARA–AORTIC LYMPH NODES: A PITFALL IN ECHOGRAPHIC ABDOMINAL AORTIC ANEURYSM DIAGNOSIS

• Published in: European heart journal supplements Vol. 25; no. Supplement_D; p. D215
• Main Authors: Natale, F, Loffredo, F, Molinari, R, Covino, S, Limatola, M, De Luca, L, Mollo, N, Alfieri, R, Pezzullo, E, Cimmino, G
• Format: Journal Article
• Language: English
• Published: 18.05.2023
• ISSN: 1520-765X; 1554-2815
• DOI: 10.1093/eurheartjsupp/suad111.500

Abstract A 65–year–old woman was scheduled for coronary angiography during the pre–surgery evaluation because of an abdominal aortic aneurysm (AAA) detected at ultrasound (Figure). The patient referred worsening dyspnoea and asthenia in the last few months, associated with atypical chest pain. Because of these symptoms and taking into account that AAA patients are very high cardiovascular risk, exclusion of coronary artery desease semmed appropriate. At admission, patient showed enlarged lymph nodes at cervical and inguinal region. In the suspicion of a malignant cancer, a contrast enhanced comupter tomography was scheduled, showing an increase in para–aortic, inguinal, cervical and maxillary lynph nodes size in absence of the AAA (figure). After blood tests and haematologic consultation, a final diagnosis of chornic myeloid leukaemia was made. The echo–colour doppler is the first line imaging test for diagnosis of AAA. However, in some cases it might be not sufficient. Para–aortic lymphadenopathy should be considered as a possible pitfall in the differential diagnosis of abdobinal aortic aneurysm.