’Healthy’ patients with abdominal lymph nodes seen on CT do not need follow-up imaging

Smaller lymph nodes commonly seen on abdominal CT scans in “healthy” people are not clinically significant and require no further imaging, a new study confirms. The study was performed because there is no standard as to what should be done about these patients so they often undergo additional testing to rule out inflammation, cancer or other diseases.

Researchers examined CT scans of 120 patients treated in the emergency room following blunt abdominal trauma that had no history of an illness that may result in lymphadenopathy. Other than evidence of trauma, the patients were healthy and CT scans were normal, said Brian C. Lucey, assistant professor of radiology at Boston Medical Center, and lead author of the study. “We found that 39% of these patients (47 of the 120) had mesenteric lymph nodes (found in the area of the abdomen near the small intestines) averaging in size about 5 mm,” Dr. Lucey said. “We examined hospital records a year after each of these patients had been examined, and there was no evidence that any of them had developed disease,” he said. Dr. Lucey notes that there is the possibility that patients could have gone to other institutions for further medical care, however, “we feel it is reasonable to believe that this group of patients is representative of the healthy population.”

“MDCT scanners and PACS computer workstations allow us to more clearly distinguish lymph nodes from vessels and other internal structures and that’s why we are seeing them more often,” Dr. Lucey noted. “Multiple small nodes scattered throughout the abdomen are common, and follow-up imaging isn’t needed” he said. However, if there are large clusters of lymph nodes or the patient has a history of cancer, then follow-up imaging may be necessary, Dr. Lucey said.

The study appeared in the January 2005 issue of the American Journal of Roentgenology.