Lymph node enlargement within the hepatoduodenal ligament in patients with chronic hepatitis C reflects the immunological cellular response of the host

Background/Aims: Lymph nodes in the hepatoduodenal ligament seem to be a common ultrasonographic finding in patients with chronic hepatitis C. Lymphadenopathic enlargement is associated with the histological hepatic features reflecting the immunological response of the host, but the correlation between lymphadenopathy, liver histology and the cellular immunoreactivity of the host has never been studied. Aim: (1) To specify the prevalence of lymph nodes within the hepatoduodenal ligament; and (2) to investigate whether lymphadenopathies might reflect the immunological response of the host. Methods: One hundred and eleven patients were enrolled in this study. Eleven chronic hepatitis B patients and 34 healthy volunteers served as controls. Results: Lymph nodes were detectable in 90 out of the 104 chronic hepatitis C patients studied. After logistic regression, a high CD8 level and the absence of post hepatitis C cirrhosis were associated with lymph node enlargement. The total lymph node volume was correlated with transaminase levels, inflammatory activity, and stage of fibrosis. Conclusions: (1) The prevalence of lymph nodes within the hepatoduodenal ligament is high; (2) lymph node enlargement is correlated with the immunological cellular response of the host; and (3) the total lymph node volume is correlated with hepatic necroinflammatory markers and the stage of fibrosis.