Abdominal lymph node size in children at computed tomography

Abstract

Background Lymph node enlargement is commonly used to indicate abnormality. Objective To evaluate the normal size and prevalence of abdominal lymph nodes in children at CT. Materials and methods In this retrospective study, we included a total of 152 children ages 1-17 years who underwent abdominal CT examination after high-energy trauma. We measured abdominal lymph nodes in five lymph node stations (inguinal, iliac, para-aortic, hepatic and mesenteric). For the largest lymph node in each level, we measured long-and short-axis diameters in both the axial and coronal planes. We then calculated distribution parameters, correlation coefficients between lymph node size and age, and reference intervals. Results The prevalence of detectable lymph nodes was high for the inguinal (100%), iliac (98%), para-aortic (97%) and mesenteric (99%) stations and lower for the hepatic station (32%). Lymph node size showed small to medium significant correlations (ranging from 0.21 to 0.50) with age. When applying the Lugano criteria and RECIST (Response Criteria in Solid Tumors), 29 children (19%) would have had one or more enlarged abdominal lymph nodes. Conclusion The results of this study provide normative data of abdominal lymph node size in children. The current adult guidelines for enlarged lymph nodes seem adequate for most children with the exception of young adolescents, in which larger lymph nodes were relatively common, particularly in the inguinal region.

Computer-Aided System Based on Deep Learning for Lymph Node Lesions Diagnosis in CT Images from Abdominal Lymphadenopathy Patients

“…Moreover, it has been shown that 5%-10% of CT-detected abdominal lymphadenopathy cases are related to benign processes rather than malignant infiltration. Unfortunately, no distinctive features distinguish benign from malignant lymphadenopathy since individual nodes greater than 2 cm and confluent node mantles may be seen in benign diseases [4,5,7,9]. Our proposed CAD system based on the ResNet-34 model showed a very high performance due to the convergence of the training loss, validation loss, and error rate to a minimum (i.e., zero) (Figure 2A to 2C).…”

“…Mesenteric adenitis is assumed to have a viral etiology and is characterized by right lower quadrant abdominal pain brought on by nodal swelling close to the ileocecal valve, which makes it difficult to distinguish from appendicitis [3]. Others include the etiologies of typhoid fever, ulcerative colitis, and non-Hodgkin lymphoma [3,4]. Lymphoma frequently results in lymphadenopathy in the chest, retroperitoneum, or superficial lymph node chains; however, mesenteric lymphadenopathy is not uncommon [5].…”

The Effect of COVID–19 on Pediatric Intussusception: A Retrospective Study of a Single Center in South Korea with 10–Year Experience

“…본 저자들은 특발성 장중첩증이 2세 미만의 어린 나이에서 더 많이 발생하는 이유가 장 직경과 림프절 크기의 불일치에 있다고 생각한다. Spijkers 등( 20 )이 발표한 연구에 의하면 정상 장간막 림프절의 크기는 0–2세에 가장 크고 이후 줄어들었다가 10대에 다시 증가한다. 위장관의 직경이 가장 작은 어린 나이에 림프절의 크기는 가장 크다는 구조적 문제가 장중첩증을 유발하는 원인이 된다고 추측한다.…”

European guideline for imaging in paediatric and adolescent rhabdomyosarcoma — joint statement by the European Paediatric Soft Tissue Sarcoma Study Group, the Cooperative Weichteilsarkom Studiengruppe and the Oncology Task Force of the European Society of Paediatric Radiology

“…Pathological lymph nodes must meet the criterion of a short axis of ≥15 mm; lymph nodes with a short axis <10 mm are considered non-pathological [ 18 , 19 ]. Although RECIST 1.1 guidelines have been developed for adult oncological patients, recent studies in healthy children and adolescents justify the use of these cut-offs with the exception of cervical lymph nodes [ 31 , 32 ]. In fact, apart from the upper internal jugular nodes (level II), a short-axis diameter exceeding 10 mm is uncommon in healthy children [ 31 ].…”