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Clinical Significance of Enlarged Perihepatic Lymph Nodes in Chronic Hepatitis B

Choi, Moon Seok M.D.; Lee, Joon Hyeok M.D.; Koh, Kwang Cheol M.D.; Paik, Seung Woon M.D.; Rhee, Poong-Lyul M.D.; Kim, Jae Jun M.D.; Rhee, Jong Chul M.D.; Choi, Kyoo Wan M.D.; Kim, Seung Hoon M.D.

Journal of Clinical Gastroenterology: April 2001 - Volume 32 - Issue 4 - p 329-332
Clinical Research

Goals To evaluate the clinical significance of enlarged perihepatic lymph nodes in patients with chronic hepatitis B.

Background Enlargement of perihepatic lymph node is a common finding during ultrasonography in patients with chronic hepatitis. Its relation with liver histology and viremia was reported in chronic hepatitis C, but little has been known about its clinical significance in chronic hepatitis B.

Study We evaluated the clinical significance of perihepatic lymphadenopathy in chronic hepatitis B. In 50 patients with biopsy-proven chronic hepatitis B and 15 healthy controls, the perihepatic lymph node volume was evaluated by ultrasonography and its possible correlation with biochemical tests, hepatitis activity index, and hepatitis B viremia was investigated.

Results Perihepatic lymph node was detected in 48 of 50 patients with chronic hepatitis B (volume = 3.4 ± 2.4 mL) and in two of 15 controls (0.4 mL and 0.6 mL). In chronic hepatitis B, lymph node volume showed a significant correlation with serum aspartate transaminase (r = 0.66), alanine transaminase (r = 0.63), gamma-glutamyl-transpeptidase (r = 0.53), histologic activity index (r = 0.59), and necroinflammatory score (r = 0.59;p < 0.05 for all), but not with fibrosis score and serum hepatitis B viremia.

Conclusions Enlarged perihepatic lymph nodes in chronic hepatitis B can be a good indicator for histologic and biochemical inflammatory activity of the liver, but not for viremia.

From the Division of Gastroenterology, Department of Medicine (M.S.C., J.H.L., K.C.K., S.W.P., P-L.R., J.J.K., J.C.R., K.W.C.), and the Department of Diagnostic Radiology (S.H.K.), Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea

Submitted May 2, 2000.

Accepted August 22, 2000.

Address correspondence and reprint requests to Dr. Joon Hyeok Lee, Division of Gastroenterology, Samsung Medical Center, #50 Ilwon-Dong, Kangnam-Gu, Seoul, Korea 135-710.

© 2001 Lippincott Williams & Wilkins, Inc.