Abstract
BackgroundLymph node enlargement is commonly used to indicate abnormality.ObjectiveTo evaluate the normal size and prevalence of abdominal lymph nodes in children at CT.Materials and methodsIn 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.ResultsThe 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.ConclusionThe 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.
Highlights
Lymph nodes in children can be enlarged for a variety of reasons, amongst which are both malignant and infectious diseases [1]
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, in the inguinal region
Inguinal: lymph nodes located below the inguinal ligament, Iliac: lymph nodes located between the aortic bifurcation and the inguinal ligament, Hepatic: lymph nodes situated along the course of the hepatic artery, Para-aortic: lymph nodes located directly around the abdominal aorta, both above and below the renal hilus; and Mesenteric: lymph nodes situated along the course of the mesenteric vessels
Summary
Lymph nodes in children can be enlarged for a variety of reasons, amongst which are both malignant and infectious diseases [1]. No specific guidelines for evaluating abdominal lymph nodes in children have been published. Criteria in Solid Tumors (RECIST) are frequently used guidelines to evaluate lymph node size. The recommended cut-off values for all lymph nodes, irrespective of location and age, are 10 mm for the short axial axis diameter (both guidelines) and 15 mm for the long axial axis diameter [3, 4]. These criteria for adults are frequently used to assess abdominal lymph nodes in children as well as in adults. Normal measurements of abdominal lymph nodes could be different for each age.
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