The clinical and imaging spectrum of pancreaticoduodenal lymph node enlargement

Zeman, R K; Schiebler, Mark L.; Lr, Clark; Jaffe, Michael H.; Dm, Paushter; Grant, E G; Pl, Choyke

doi:10.2214/ajr.144.6.1223

Cited by 40 publications

(4 citation statements)

References 6 publications

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“…Lymphatics draining the descending colon lead to the inferior mesenteric lymph node Similar regional patterns are also described in humans, although in the duodenum the lymph drainage parallels the more complex blood supply arising from both the gastroduodenal and superior mesenteric arteries. The anterior duodenal lymphatics drain to the duodenopancreatic lymph nodes along the superior and inferior pancreatoduodenal arteries branching from the gastroduodenal artery, while the posterior duodenal lymphatics drain to the superior mesenteric lymph nodes (1204). The distinct lymph nodes assigned to different functional parts of the small and large intestine, which likely have differences in lymph composition, may confer specialized immunological properties for each lymph node (733).…”

Section: Organization and Anatomy Of The Lymphatic Systemmentioning

confidence: 99%

Lymphatic Vessel Network Structure and Physiology

Breslin

Yang

Scallan

et al. 2018

Comprehensive Physiology

272

258

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The lymphatic system is comprised of a network of vessels interrelated with lymphoid tissue, which has the holistic function to maintain the local physiologic environment for every cell in all tissues of the body. The lymphatic system maintains extracellular fluid homeostasis favorable for optimal tissue function, removing substances that arise due to metabolism or cell death, and optimizing immunity against bacteria, viruses, parasites, and other antigens. This article provides a comprehensive review of important findings over the past century along with recent advances in the understanding of the anatomy and physiology of lymphatic vessels, including tissue/organ specificity, development, mechanisms of lymph formation and transport, lymphangiogenesis, and the roles of lymphatics in disease.

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Section: Organization and Anatomy Of The Lymphatic Systemmentioning

confidence: 99%

Lymphatic Vessel Network Structure and Physiology

Breslin

Yang

Scallan

et al. 2018

Comprehensive Physiology

272

258

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“…Non-Hodgkin's lymphoma may involve peripancreatic lymph nodes or may directly invade the pancreas [58]. Intermediate-signal-intensity peripancreatic lymph nodes are distinguished from high-signal-intensity pancreas on T1-weighted fat-suppressed images.…”

Section: Lymphomamentioning

confidence: 99%

MRI of pancreatic tumors

Kelekis

Semelka

1997

Eur Radiol

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MRI employing current imaging techniques is able to detect various pancreatic tumors well, and is able to stage and characterize tumors accurately. This review article describes various current MR techniques emphasizing breath hold spoiled gradient echo (SGE) imaging, fat suppression, dynamic gadolinium administration and MR cholangiographic techniques. Pancreatic ductal adenocarcinomas are generally low signal intensity on T1-weighted and T2-weighted images and enhance poorly on immediate post gadolinium SGE images. Islet cell tumors are generally low signal intensity on T1-weighted images, high signal intensity on T2-weighted images and enhance intensely on immediate post gadolinium images. The appearances of less common tumors is also described.

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“…In our series, however, nodal involvement was clearly demonstrated on CT in 12.3 % of 267 patients with CC of the stomach (33 patients), 32 % of 25 patients with CC of the gallbladder (8 patients), 11 % of 27 patients with CC of the bile ducts (3 patients), and 15.3 % of 98 patients with HCC (15 patients). Moreover, involvement of the peripancreatic and aortocaval group of lymph nodes can be confused with more commonly encountered malignancies, such as CC of the pancreas and diffuse retroperitoneal lymphoma, respectively, because of similar configuration in the same anatomic location [14]. This confusing configuration was seen at presentation in 2 patients with gallbladder CC and 1 patient with CC of the stomach, and in 2 patients, one from each case, pancreatic carcinoma was initially diagnosed both clinically and radiologically.…”

Section: Discussionmentioning

confidence: 99%

Pathways of lymph node involvement in upper abdominal malignancies: evaluation with high-resolution CT

et al. 1999

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The aim of this study was to enhance our understanding of the pathways of lymphatic spread of primary carcinomas in the upper abdomen by recognizing the development, configuration, and frequency of nodal enlargement in discrete anatomic regions. The study included 417 patients with histologically confirmed carcinomas (CC) of the stomach (n = 267), liver (n = 98), gallbladder (n = 25), and bile ducts (n = 27). All patients were studied by high-resolution CT and tumor extension to the lymph nodes of the subperitoneal space was clearly identified in 59 patients [33 with CC of the stomach, 8 with CC of the gallbladder, 3 with CC of the bile ducts, and 15 with hepatocellular carcinoma (HCC)]. In 47 of 59 patients this extension was confirmed by surgery or aspiration biopsy. Three discrete anatomic groups of lymph nodes were recognized producing a relatively distinct CT configuration when involved: (a) the hepatoduodenal seen in 49 patients; (b) the peripancreatic demonstrated in 33 patients; and (c) the aortocaval recognized in 16 patients. These groups of lymph nodes can be seen individually involved or in combination. Recognition of involvement of these nodes is important for correct diagnosis and staging of upper abdominal malignancies. The development of this involvement follows the natural flow of lymph via the lesser omentum to the retroperitoneal space.

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The clinical and imaging spectrum of pancreaticoduodenal lymph node enlargement

Cited by 40 publications

References 6 publications

Lymphatic Vessel Network Structure and Physiology

Lymphatic Vessel Network Structure and Physiology

MRI of pancreatic tumors

Pathways of lymph node involvement in upper abdominal malignancies: evaluation with high-resolution CT

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