Lymphadenopathy below the Renal Hilum: Useful in Differentiation between Gastric Adenocarcinoma and Gastric Lymphoma?

Yoon, Jong Hoon; Kang, Heoung Keun; Kim, Yun Hyun; Jeong, Yong Yeon; Seo, Jeong Jin; Chung, Tae Woong; Park, Jin Gyoon

Abstract

Purpose
To evaluate whether the lymphadenopathy below the renal hilum on the abdominal CT could be useful for differentiation between gastric adenocarcinoma and gastric lymphoma. Materials and Methods: We retrospectively analyzed the frequency, distribution, contrast enhancing pattern, and size of lymphadenopathy below the renal hilum on abdominal CT in 2233 cases of pathologically proven malignant gastric tumors (2210 cases of gastric adenocarcinoma and 23 cases of gastric lymphoma). Results: The lymphadenopathy below the renal hilum was found in 12 cases of gastric adenocarcinomas(12/2210, 0.54%) and 6 cases of gastric lymphomas(6/23, 23%). The enhancement(5/12, 42%), 5 cases of homogeneous enhancement(5/12, 42%) and 2 cases of mixed enhancement(2/12, 16%) in gastric adenocarcinomas, and homogeneous enhancemtnt in all of the gastric lymphomas. The size of lymphadenopathy was 8-52mm(average, 16mm) in gastric carcinomas and 10-60mm(average, 21mm) in gastric lymphomas. Conclusion: The lymphadenopathy below the renal hilum was much more frequently encountered in gastric adenocarcinomas than in gastric lymphomas because of large numbers of patients with adenocarcinoma. Consequently the presence of lymphadenopathy below the renal hilum was not sensitive in differentiation between gastric adenocarcinoma and lymphoma, but homogeneous contrast enhancement of lymphadenopathy was favorable finding for gastric lymphoma.