Differentiate TB From Lymphomas

Abdominal tuberculosis can affect the gastrointestinal tract, peritoneum, and lymph nodes. When the prevalence of abdominal tuberculosis is high, it’s difficult to establish its diagnosis. Lymphadenopathy is the most common manifestation of abdominal tuberculosis and is easily confused with lymphomas involving abdominal lymph nodes in up to 55 percent of cases without other evidence of abdominal involvement. Clinical and radiologic differentiation between the two can be challenging.

To improve the physicians’ ability to distinguish between these entities, a team of researchers at Weifang Medical University of China conducted a comparison of computed tomography (CT) findings in tuberculosis and non-Hodgkin’s lymphoma (NHL) involving the small bowel mesentery (SBM). You might be surprised at their discovery.

They found CT showed tuberculosis and NHL mainly affected lymph nodes in the body and root of SBM. Homogeneously enhanced lymph nodes in the body and root of SBM were found more often in the NHL (P < 0.05). Homogeneously mixed peripheral enhanced lymph nodes in the body of SBM were found more often in mesenteric TL and TLM (P < 0.05). Peripheral enhanced lymph nodes in the root of SBM were found more often in mesenteric TL and TLM (P < 0.01). “Sandwich sign” in the root of SBM was observed more often in NHL (P < 0.05).

The research team concluded anatomic lymph node distribution, sandwich sign and specific enhancement patterns of lymphadenopathy in SBM on CT images can be used to differentiate between tuberculosis and untreated NHL involving SBM.

To learn more, read the research article, published on the World Journal of Gastroenterology Web site.

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