DOI: 10.1148/rg.252045108
Mesenteric Lymph Nodes Seen at Imaging: Causes and Significance1
Brian C. Lucey, MD,
Joshua W. Stuhlfaut, MD and
Jorge A. Soto, MD
1 From the Department of Radiology, Boston Medical Center, 88 E Newton St, Atrium 2, Boston, MA 02118. Presented as an education exhibit at the 2003 RSNA Scientific Assembly. Received May 18, 2004; revision requested June 30 and received July 20; accepted July 26. All authors have no financial relationships to disclose.
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Figure 1a. Normal mesenteric nodes in a 17-year-old boy who experienced blunt abdominal trauma. CT images (a obtained at a higher level than b) show normal lymph nodes in the mesentery (arrow).
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Figure 1b. Normal mesenteric nodes in a 17-year-old boy who experienced blunt abdominal trauma. CT images (a obtained at a higher level than b) show normal lymph nodes in the mesentery (arrow).
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Figure 2a. Coalescent nodes in a 42-year-old man with lymphoma. (a) CT image shows a homogeneous conglomerate mass formed by mesenteric and retroperitoneal lymphadenopathy (arrows). (b) CT image shows that the mass surrounds but does not occlude the mesenteric vessels (arrows). (c) CT image shows that the mass displaces bowel loops but does not occlude them (arrows).
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Figure 2b. Coalescent nodes in a 42-year-old man with lymphoma. (a) CT image shows a homogeneous conglomerate mass formed by mesenteric and retroperitoneal lymphadenopathy (arrows). (b) CT image shows that the mass surrounds but does not occlude the mesenteric vessels (arrows). (c) CT image shows that the mass displaces bowel loops but does not occlude them (arrows).
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Figure 2c. Coalescent nodes in a 42-year-old man with lymphoma. (a) CT image shows a homogeneous conglomerate mass formed by mesenteric and retroperitoneal lymphadenopathy (arrows). (b) CT image shows that the mass surrounds but does not occlude the mesenteric vessels (arrows). (c) CT image shows that the mass displaces bowel loops but does not occlude them (arrows).
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Figure 3a. Persistent lymphadenopathy in a 62-year-old woman with lymphoma. (a) CT image shows lymphadenopathy in the mesentery of the right lower quadrant (arrow). (b) Posttreatment CT image obtained 2 years later shows persistent, unchanged lymphadenopathy (arrow). The disease was in remission when this image was obtained.
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Figure 3b. Persistent lymphadenopathy in a 62-year-old woman with lymphoma. (a) CT image shows lymphadenopathy in the mesentery of the right lower quadrant (arrow). (b) Posttreatment CT image obtained 2 years later shows persistent, unchanged lymphadenopathy (arrow). The disease was in remission when this image was obtained.
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Figure 4a. Mesenteric lymphadenopathy in a 38-year-old man with carcinoid tumor. (a) CT image shows a primary soft-tissue mass (arrows). (b) Non-enhanced CT image obtained 1 year later shows recurrence in a mesenteric lymph node (arrows). (c) Contrast-enhanced CT image obtained at the same time as b shows minimal enhancement of the nodal mass (arrows).
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Figure 4b. Mesenteric lymphadenopathy in a 38-year-old man with carcinoid tumor. (a) CT image shows a primary soft-tissue mass (arrows). (b) Non-enhanced CT image obtained 1 year later shows recurrence in a mesenteric lymph node (arrows). (c) Contrast-enhanced CT image obtained at the same time as b shows minimal enhancement of the nodal mass (arrows).
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Figure 4c. Mesenteric lymphadenopathy in a 38-year-old man with carcinoid tumor. (a) CT image shows a primary soft-tissue mass (arrows). (b) Non-enhanced CT image obtained 1 year later shows recurrence in a mesenteric lymph node (arrows). (c) Contrast-enhanced CT image obtained at the same time as b shows minimal enhancement of the nodal mass (arrows).
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Figure 5. Nodal involvement in a 71-year-old man with esophageal carcinoma. CT image shows extensive mesenteric lymphadenopathy (arrow). The surrounding mesenteric stranding may be related to tumor infiltration or edema.
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Figure 6a. Nodal involvement in a patient with appendiceal carcinoma. (a) CT image shows a soft-tissue mass in the region of the appendix (arrows). (b) CT image shows enlarged lymph nodes (arrows) around the mass.
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Figure 6b. Nodal involvement in a patient with appendiceal carcinoma. (a) CT image shows a soft-tissue mass in the region of the appendix (arrows). (b) CT image shows enlarged lymph nodes (arrows) around the mass.
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Figure 7a. Nodal involvement in a 51-year-old man with gastric carcinoma. (a) CT image shows a concentrically thickened gastric antrum (arrows). (b) CT image shows small mesenteric lymph nodes (arrows), which contained tumor at resection.
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Figure 7b. Nodal involvement in a 51-year-old man with gastric carcinoma. (a) CT image shows a concentrically thickened gastric antrum (arrows). (b) CT image shows small mesenteric lymph nodes (arrows), which contained tumor at resection.
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Figure 8. Local lymphadenopathy in a 68-year-old woman with colonic carcinoma. CT image shows mesenteric lymphadenopathy (arrows), which is easily seen against the intraabdominal fat.
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Figure 9. Mesenteric lymphadenopathy in a 54-year-old woman with metastatic malignant melanoma. The patient underwent resection of a skin lesion 4 years earlier. CT image shows low-attenuation lymphadenopathy (arrows). This appearance is not typical of malignant melanoma, which usually has homogeneous soft-tissue attenuation. Note the compression of the inferior vena cava (arrowhead).
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Figure 10. Mesenteric lymphadenopathy in a 68-year-old patient with chronic lymphatic leukemia. CT image shows extensive bulky lymphadenopathy both at the mesenteric root and throughout the periphery of the mesentery (arrows).
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Figure 11a. Mesenteric lymphadenopathy in a 38-year-old man with AIDS and Kaposi sarcoma. (a) CT image shows a homogeneous soft-tissue mass formed by mesenteric lymphadenopathy (top arrow). The mass surrounds the mesenteric vessels (bottom arrows) but does not occlude them. (b) CT image shows that the lymphadenopathy may also take the form of discrete masses in the mesentery (arrows).
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Figure 11b. Mesenteric lymphadenopathy in a 38-year-old man with AIDS and Kaposi sarcoma. (a) CT image shows a homogeneous soft-tissue mass formed by mesenteric lymphadenopathy (top arrow). The mass surrounds the mesenteric vessels (bottom arrows) but does not occlude them. (b) CT image shows that the lymphadenopathy may also take the form of discrete masses in the mesentery (arrows).
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Figure 12. Isolated lymphadenopathy in a 72-year-old woman with an unsuspected small bowel perforation, diagnosis of which was delayed. CT image shows isolated mesenteric lymphadenopathy (arrows), which represents an inflammatory response.
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Figure 13a. Local lymphadenopathy due to appendicitis. (a) CT image of a 28-year-old woman with acute appendicitis shows a thickened appendix (long arrow). Lymph nodes are present in the mesentery of the right lower quadrant (arrowhead) along with stranding of the mesenteric fat (short arrow), which reflects the inflammatory process. (b) CT image of a 24-year-old woman with acute appendicitis shows multiple lymph nodes in the mesentery of the right lower quadrant (arrowheads).
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Figure 13b. Local lymphadenopathy due to appendicitis. (a) CT image of a 28-year-old woman with acute appendicitis shows a thickened appendix (long arrow). Lymph nodes are present in the mesentery of the right lower quadrant (arrowhead) along with stranding of the mesenteric fat (short arrow), which reflects the inflammatory process. (b) CT image of a 24-year-old woman with acute appendicitis shows multiple lymph nodes in the mesentery of the right lower quadrant (arrowheads).
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Figure 14. Normal mesenteric node in a 32-year-old man who experienced blunt abdominal trauma. CT image shows a normal lymph node in the mesentery of the right lower quadrant (arrow). The results of the CT study were otherwise unremarkable.
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Figure 15. Mesenteric lymphadenopathy in a 48-year-old woman with acute pancreatitis. CT image shows mesenteric lymph nodes (arrows). There is extensive inflammatory stranding throughout the mesentery.
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Figure 16a. Mesenteric lymphadenopathy in a 40-year-old man with Crohn disease. CT images show lymphadenopathy throughout the periphery of the mesentery (arrows in a) and in the mesentery of the right lower quadrant (arrow in b).
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Figure 16b. Mesenteric lymphadenopathy in a 40-year-old man with Crohn disease. CT images show lymphadenopathy throughout the periphery of the mesentery (arrows in a) and in the mesentery of the right lower quadrant (arrow in b).
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Figure 17. Mesenteric lymphadenopathy in a 33-year-old woman with Crohn disease. CT image shows lymphadenopathy at the mesenteric root (arrows).
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Figure 18. Mesenteric lymphadenopathy in a 43-year-old man who presented with abdominal pain. CT image shows multiple enlarged lymph nodes in the mesentery (arrows). Note the inflammatory changes in the surrounding mesentery (arrowhead). This finding represents mesenteric panniculitis.
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Figure 19. Mesenteric lymphadenopathy in a 34-year-old woman with mesenteric panniculitis. CT image shows lymph nodes with increased mesenteric attenuation (arrows).
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Figure 20a. Mesenteric lymphadenopathy in a 44-year-old woman with systemic lupus erythematosus. CT images (a obtained at a higher level than b) show multiple enlarged lymph nodes throughout the mesentery (arrows).
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Figure 20b. Mesenteric lymphadenopathy in a 44-year-old woman with systemic lupus erythematosus. CT images (a obtained at a higher level than b) show multiple enlarged lymph nodes throughout the mesentery (arrows).
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Figure 21. Mesenteric lymphadenopathy in a 40-year-old man with a history of sarcoidosis who presented with nonspecific abdominal pain. CT image shows multiple enlarged lymph nodes at the splenic hilum (arrows).
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Figure 22. CT image of a 40-year-old man with a long history of primary amyloidosis shows mesenteric lymphadenopathy (arrows).
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Figure 23a. Mesenteric lymphadenopathy in a 28-year-old man who presented with acute abdominal pain. CT images show innumerable lymph nodes in the mesentery of the right lower quadrant (arrows in a) and at the mesenteric root (arrows in b). The CT findings were otherwise unremarkable. This appearance represents mesenteric adenitis.
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Figure 23b. Mesenteric lymphadenopathy in a 28-year-old man who presented with acute abdominal pain. CT images show innumerable lymph nodes in the mesentery of the right lower quadrant (arrows in a) and at the mesenteric root (arrows in b). The CT findings were otherwise unremarkable. This appearance represents mesenteric adenitis.
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Figure 24a. Mesenteric lymphadenopathy in a 28-year-old man with HIV infection. The patient presented with flank pain, and the CT study was performed as a renal stone protocol with the patient prone. (a) CT image shows multiple lymph nodes scattered throughout the mesentery (arrows). (b) CT image obtained 15 months later for evaluation of abdominal pain shows that the enlarged lymph nodes have resolved.
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Figure 24b. Mesenteric lymphadenopathy in a 28-year-old man with HIV infection. The patient presented with flank pain, and the CT study was performed as a renal stone protocol with the patient prone. (a) CT image shows multiple lymph nodes scattered throughout the mesentery (arrows). (b) CT image obtained 15 months later for evaluation of abdominal pain shows that the enlarged lymph nodes have resolved.
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Figure 25. Mesenteric lymphadenopathy in a 39-year-old man with HIV and MAC infection. CT image shows extensive mesenteric lymphadenopathy of uniform soft-tissue attenuation (arrows). The lymph nodes are discrete with no formation of a conglomerate mass and no displacement of vessels or intestine.
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Figure 26. Mesenteric lymphadenopathy in a 34-year-old woman with HIV and MAC infection. CT image shows multiple discrete mesenteric lymph nodes (arrows), all of which have uniform soft-tissue attenuation.
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Copyright © 2005 by the Radiological Society of North America.
