The incidence of tuberculosis is increasing. Lymphadenopathy is the most common manifestation of abdominal tuberculosis and may, in up to 55% of cases without other evidence of abdominal involvement, be easily confused with lymphomas involving abdominal lymph nodes. Clinical and radiologic differentiation between the two can be challenging. A comparison of CT findings in tuberculosis and lymphoma of the mesenteric lymph nodes has not been reported.
A research article to be published on 28 June 2008, in the World Journal of Gastroenterology addresses this question. The research team led by Dr. Dong P from Weifang Medical University of China has determined that tuberculosis and non-Hodgkin's lymphomas (NHL) mainly affected the lymph nodes in the body and root of the SBM on CT images. Homogeneous enhanced lymph nodes in the body and root of SBM were more often in the NHL (P < 0.05). Homogeneous mixed with peripheral enhanced lymph nodes in the body of SBM were more often in mesenteric TL and TLM (P < 0.05). Peripheral enhanced lymph nodes in the root of SBM were more often in mesenteric TL and TLM (P < 0.01). "Sandwich sign" in the root of SBM was more often in NHL (P < 0.05). The result is helpful in differentiating between tuberculosis and untreated NHL involving the small bowel mesentery (SBM).
Tuberculosis demonstrates a variety of clinical and radiologic features depending on the organ site involved and has a known propensity for dissemination from its primary site. Lymphadenopathy is the most common manifestation of abdominal tuberculosis and may, in up to 55% of cases without other evidence of abdominal involvement, be easily confused with lymphomas involving abdominal lymph nodes. It is important to be familiar with the various radiologic features of tuberculosis and NHL involving the SBM to ensure accurate diagnosis.
The incidence of tuberculosis is increasing. Lymphadenopathy is the most common manifestation of abdominal tuberculosis. Currently, the comparison of CT findings in tuberculosis and lymphomas involving the SBM has not been published in english radiologic literature.
CT manifestations of tuberculosis and NHL mainly affected the lymph nodes in the body and root of the SBM. Homogeneous enhanced lymph nodes in the body and root of SBM were more often in the NHL (P < 0.05). Homogeneous mixed with peripheral enhanced lymph nodes in the body of SBM were more often in mesenteric TL and TLM (P < 0.05). Peripheral enhanced lymph nodes in the root of SBM were more often in mesenteric TL and TLM (P < 0.01). "Sandwich sign" in the root of SBM was more often in NHL (P < 0.05).
In the view of the authors, the CT can show the specific enhancement patterns of lymphadenopathy, sandwich sign and anatomic lymph nodes distribution in tuberculosis and untreated NHL involving the SBM.
This article describes the difference between tuberculosis and NHL involved the SBM, and CT is helpful to the diagnosis and differential diagnosis of the tuberculosis and NHL involving the SBM.
Further research should compare the CT findings of mesenteric tuberculosis with metastatic malignancy and other entities which involved the SBM.