The clinical and imaging spectrum of pancreaticoduodenal lymph node enlargement

AJR Am J Roentgenol. 1985 Jun;144(6):1223-7. doi: 10.2214/ajr.144.6.1223.


Pancreaticoduodenal lymph node enlargement, regardless of cause, has been a source of imaging confusion because of its propensity to mimic pancreatic malignancy yet not cause biliary obstruction. Thirty-eight patients with pancreaticoduodenal adenopathy were imaged with several methods. Pancreaticoduodenal lymphadenopathy could be distinguished from intrinsic pancreatic abnormality on only 44% (14/32) of CT scans and 54% (6/11) of sonograms. Demonstration of intact tissue planes separating adenopathy from pancreas and, to a lesser degree, extrapancreatic vascular displacement were the most helpful diagnostic signs. Surprisingly, 31% of patients had biliary obstruction. Care must be taken in distinguishing metastatic lymphadenopathy from primary pancreatic tumors. The presence or absence of jaundice should not be considered a helpful sign.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Duodenal Diseases / diagnosis*
  • Duodenal Diseases / diagnostic imaging
  • Female
  • Humans
  • Lymphatic Diseases / diagnosis*
  • Lymphatic Diseases / diagnostic imaging
  • Male
  • Middle Aged
  • Pancreatic Diseases / diagnosis*
  • Pancreatic Diseases / diagnostic imaging
  • Tomography, X-Ray Computed
  • Ultrasonography