The presence of cardiophrenic angle lymph nodes is not an indicator of peritoneal carcinomatosis from colorectal cancer on MDCT: Results of a case-control study

Abstract

Objective: To determine if the presence of cardiophrenic angle lymph nodes (CPALNs) on multidetector-row computed tomography (MDCT) can be considered as an indicator of peritoneal carcinomatosis (PC) in patients with colorectal cancer (CRC).

Material and methods: Two groups of 101 patients each were retrospectively included. Group 1 included patients with PC from CRC and Group 2 included patients with CRC without PC. MDCT examinations were analyzed by two readers working in consensus for the presence or absence of CPALNs and, when present for their dimensions (short and long axis), location (right, left or bilateral) and shape (oval or rounded).

Results: Prevalence of CPALNs was 29% in Group 1 and 32% in Group 2. No differences in prevalence of CPALNs were found between the two groups (P = 0.458). Presence of CPALNs had a sensitivity of 29% (95%CI: 23-35%) for the diagnosis of PC and a specificity of 68% (95%CI = 62-74%). No differences in CPALN dimensions, location and shape were found between these two groups.

Conclusion: Presence of CPALNs cannot be considered as an indicator of PC in patients with CRC. In addition, when present, CPALNs have similar dimensions, location and shapes in patients with PC from CRC than in those without PC.

Keywords: Cardiophrenic angle lymph nodes; Colorectal cancer; Computed tomography; Peritoneal carcinomatosis.