Gastrohepatic ligament lymph node enlargement
Diagnosis almost certain
Updates to Case Attributes
Title
was changed:
Gastrohepatic ligament lymphnodelymph node enlargement
Body
was changed:
An endoscopy was performed and a gastric ulcer found. Biopsies of the ulcer showed no evidence of malignancy malignancy. The final diagnosis is gastric ulcer with reactive lymphadenopathylymph node enlargement.
95% of gastric ulcers are benign. Twenty to thirty percent20-30% are multiple. Major risk factors include:
- H. pylori infection
and - non-steroidal anti-inflammatory drugs
.(NSAIDs)
Minor risks include factors include:
- steroids
, - smoking
, - alcohol
, - coffee
, and - stress
.
Less common causes include Zollinger Zollinger-Ellison syndrome,hyperparathyroidism, hyperparathyroidism, head injury (Cushing ulcer), or burns (Curling ulcer).
-<p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 14px; margin-left: 0px; ">This 39 year-old male patient presented with epigastric pain. The contrast-enhanced CT above shows multiple rounded structures in the region of the gastrohepatic ligament (click image for arrows). The structures do not enhance to the same degree as the portal vein, making gastric varices unlikely. The structures most probably represent enlarged lymph nodes. The scan also demonstrated moderate thickening of the gastric wall (not shown). The differential diagnosis included: gastritis or gastric ulcer with reactive lymphadenopathy; gastric lymphoma; gastrointestinal stromal tumour; and gastric carcinoma.</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 14px; margin-left: 0px; ">An endoscopy was performed and a gastric ulcer found. Biopsies of the ulcer showed no evidence of malignancy. The final diagnosis is gastric ulcer with reactive lymphadenopathy.</p><p style="padding-top: 0px; padding-right: 0px; padding-bottom: 0px; padding-left: 0px; margin-top: 0px; margin-right: 0px; margin-bottom: 14px; margin-left: 0px; ">Ninety-five percent of gastric ulcers are benign. Twenty to thirty percent are multiple. Major risk factors include H. pylori infection and non-steroidal anti-inflammatory drugs. Minor risks include steroids, smoking, alcohol, coffee, and stress. Less common causes include Zollinger-Ellison syndrome,hyperparathyroidism, head injury (Cushing ulcer), or burns (Curling ulcer).</p>- +<p>An endoscopy was performed and a gastric ulcer found. Biopsies of the ulcer showed no evidence of malignancy. The final diagnosis is <strong>gastric ulcer with reactive lymph node enlargement</strong>.</p><p>95% of <a title="Malignant and benign gastric ulcer" href="/articles/malignant-vs-benign-gastric-ulcer-barium-meal">gastric ulcers</a> are benign. 20-30% are multiple. Major risk factors include:</p><ul>
- +<li>H. pylori infection</li>
- +<li>non-steroidal anti-inflammatory drugs (NSAIDs) </li>
- +</ul><p>Minor risks factors include:</p><ul>
- +<li>steroids</li>
- +<li>smoking</li>
- +<li>alcohol</li>
- +<li>coffee</li>
- +<li>stress</li>
- +</ul><p>Less common causes include Zollinger-Ellison syndrome, hyperparathyroidism, head injury (Cushing ulcer), or burns (Curling ulcer).</p>
Presentation
was added:
Epigastric pain.
Gender
was set to
Male.
Age
was set to
39 years.
Updates to Study Attributes
Findings
was added:
Multiple rounded structures in the region of the gastrohepatic ligament. The structures do not enhance to the same degree as the portal vein, making gastric varices unlikely. The structures most probably represent enlarged lymph nodes. The scan also demonstrated moderate thickening of the gastric wall (not shown).
Images Changes:
Image CT (C+ portal venous phase) ( update )
Perspective
was set to
Axial.
Single Or Stack Root
was set to
.
Specifics
was set to
C+ portal venous phase.
Description
was removed:
Updates to Quizquestion Attributes
Question
was added:
What is the differential diagnosis?
Answer
was added:
Gastritis or gastric ulcer with reactive lymphadenopathy; gastric lymphoma; gastrointestinal stromal tumour; and gastric carcinoma.