J Korean Radiol Soc.  1987 Apr;23(2):254-262. 10.3348/jkrs.1987.23.2.254.

Computed tomographic feature of regional lymph nodes involvement in primary hepatocellular carcinoma

• Kim KW
• Yoo HS
• Lee JT
• Chung TS
• Suh JH
• Auh YH

• KMID: 2359634
• DOI: http://doi.org/10.3348/jkrs.1987.23.2.254

Abstract

The resectability of hepatocellular carcinoma is determined by the extent of hepatic involvement, the presenceor abscence of venous invasion and the presence or abscence of extrahepatic metastasis. Extrahepatic spread toregional lymph node represent contraindincation to surgical resection. Despite the importance of regional nodemetastasis, their CT appearance is poorly understood. 19 cases of hepatoma collected during Oct. 1982 to May 1985at New York Hospital-Cornell Medical center and 73 cases of hepatoma collected during Mar, 1985 to Sept. 1986 atYonsei University Medical College were reviewed and analysed. Regional lymph node involvement were divided intofour main groups with subgrouping accoridng to the location and lymphatic pathway. 1. lymph nodes in lesseromentum: hepatic, portocaval, left gastric and celiac nodes. 2. lymph nodes around pancrease head: subpyloric,superior mesenteric, preaortic retropancreatic, and precaval retropancreatic lymph nodes. 3. paraaortic nodes:left paraaortic, interaorticocaval, retrocaval and preaortic below 3rd duodenum. 4. phrenic nodes: lowerparasternal, middle phrenic and retrocrural nodes The results were as follows: 1. The frequency of regional nodeinvolvement, cases collected at New York Hospital-Cornel Medical center, is hepatic node in 5(26.3%) , portocavalnode in 8(42.1%), celiac in 7(36.8%), precaval retropancreatic in 5(26.3%) preaortic retropancreatic in 4(21.1%)interaoticocaval in 7(36.8%) retrocaval in 4(21.1%) and lower parasternal in (5.3%). 2. The frequency of regionalnode involvement, cases collected at Yonsei University college of Medicine, is hepatic in 20.5%, portocaval in24.7% left gastric in 19.2% celiac in 19.2%, precaval retropancreatic in 8.2%, preaotic retropancreatic in 5.5%,left paraaortic in 12.3%, interaorticocaval in 12.3%, retrocaval in 11.0% low parasternal in 0.8%, superiormesenteric in 4.1% subpyloric 1.4% and preaortic below 3rd duodenum in 1.4%. 3. High chance of regional nodeinvolvement can be found in nodes in lesser omentum which located in the main lymphatic pathway, followed byparaaortic lymphnode involvement via retropancreatic lymph node involvement.

MeSH Terms

Carcinoma, Hepatocellular*
Duodenum
Head
Lymph Nodes*
Neoplasm Metastasis
Omentum
Pancreas
Pancrelipase
Pancrelipase