Tuberculosis versus lymphoma in the abdominal lymph nodes: A comparative study using contrast-enhanced MRI

• Published in: European journal of radiology Vol. 81; no. 10; pp. 2513 - 2517
• Main Authors: Shao, Heng, Yang, Zhi-gang, Deng, Wen, Chen, Jing, Tang, Si-shi, Wen, Ling-yi
• Format: Journal Article
• Language: English
• Published: Ireland Elsevier Ireland Ltd 01.10.2012
• Subjects: Abdomen; Adult; Contrast Media; Diagnosis, Differential; Female; Gadolinium DTPA; Humans; Lymph node; Lymph Nodes - pathology; Lymphoma; Lymphoma - pathology; Magnetic Resonance Imaging - methods; Male; MR imaging; Radiology; Reproducibility of Results; Sensitivity and Specificity; Tuberculosis; Tuberculosis, Pulmonary - pathology; Tuberculosis; MR imaging; Lymph node; Lymphoma; Abdomen
• ISSN: 0720-048X; 1872-7727
• DOI: 10.1016/j.ejrad.2011.11.004

Abstract Purpose The purpose of this study was to determine the differential characteristics on MRI between tuberculosis and lymphoma in abdominal lymph nodes. Materials and methods We conducted a retrospective analysis for the counter, size, signal intensity, enhancement patterns, and anatomic distribution of lymph nodes in 57 consecutive patients with documented tuberculosis (28 patients; 49.1%) and newly diagnosed, untreated lymphoma (29 patients; 50.9%). Results Twenty-four cases (85.7%) in the tuberculosis group were hyperintense on T2-weighted images and either hypointense or isointense on T1-weighted images with respect to the abdominal wall muscle. All cases in the lymphoma group were hyperintense on T2-weighted images and isointense on T1-weighted images with respect to the abdominal wall muscle. Concerning the main anatomic distribution of lymph nodes, the lymph nodes in the lower paraaortic region were more frequently involved in the lymphoma group (48.3%) than in tuberculosis (17.9%, p < 0.05). Moreover, mesenteric lymph nodes were more often involved in tuberculosis (32.1%) than in lymphoma (6.9%, p < 0.05). Tuberculous lymphadenopathy showed predominantly peripheral enhancement, frequently with a multilocular appearance; whereas lymphomatous adenopathy often demonstrated uniform homogeneous enhancement (all p < 0.001). Conclusion Contrast-enhanced MRI can be useful in differentiation between these two entities.