Objectives

1. Review the normal cross-sectional and imaging appearance of abdominopelvic nodal groups.

2. Review size and morphologic criteria for abdominopelvic lymphadenopathy.

3. llustrate normal structures that can be misinterpreted as lymphadenopathy.

4. Highlight ancillary imaging and clinical clues associated with benign abdominopelvic lymphadenopathy.

5. Innumerate myriad causes of benign abdominopelvic lymphadenopathy and illustrate case examples on CT and MRI.

Background

1. When lymphadenopathy is detected on imaging, the key question facing the radiologist is whether it is due to a malignant or benign cause.

2. The radiologist plays a critical role in determining if further evaluation is indicated to diagnose malignancy, if further management of infection or inflammatory disease is indicated, or if findings are of no clinical significance.

3. Correlation with pertinent clinical history and laboratories can provide clues to benign lymphadenopathy.

4. When prior imaging confirms long-standing lymphadenopathy, benign lymphadenopathy can be considered.

Imaging findings OR Procedure findings

Causes of Benign Abdominopelvic Lymphadenopathy:

-Liver Disease

-Hemosiderosis

-Mesenteric Adenitis

-Infection

-Tuberculosis

-Appendicitis

-Colitis

-Crohn’s Disease

-Mesenteric Panniculitis

-Castleman Disease

-Whipple Disease

-Sarcoidosis

-Mastocytosis

-Autoimmune Disease

-Kikuchi-Fujimoto Disease

-Rosai Dorfman Disease

-Amyloidosis

-Gaucher’s Disease

-Drugs

Conclusion

1. The radiologist plays a major role in guiding management of lymphadenopathy, so understanding the etiologies and clinical settings in which benign lymphadenopathy is present can aid radiologic confidence of benign disease and avoid unnecessary work-up.

2. The unique imaging features of tuberculous lymphadenopathy greatly aids its diagnosis.

3. When lymphadenopathy is of indeterminate nature, short-term imaging follow-up may be an alternative to immediate biopsy.