吉岡 二三¹, 北村 次男², 田中 幸子², 山本 貴代美², 高橋 麻里², 安永 幸二郎¹

Fumi YOSHIOKA¹, Tsugio KITAMURA², Sachiko TANAKA², Kiyomi YAMAMOTO², Mari TAKAHASHI², Kojirou YASUNAGA¹

¹関西医科大学第一内科, ²大阪府立成人病センター

¹The 1st Department of Internal Medicine, Kansai Medical University, ²The Center for Adult Diseases, Osaka

キーワード : Ultrasonography, Malignant lymphoma, Lymph node, Superior mesenteric artery, Aorta

To enable us to detect lymph node swelling (LN) between the aorta and the superior mesenteric artery (SMA) in cases of malignant lymphoma (ML) by ultrasonography, we investigated whether the aortomesenteric distance and angle could be a clue to detect LN. We also investigated the influence of the obesity ratio on the aortomesenteric distance and angle. The subjects of our study were 11 cases of ML with LN (6.7%), 50 cases of ML without LN (30.3%), 4 cases of other diseases with LN (2.4%) in period of examination from December 1986 to February 1989 and 100 cases of control group (60.6%) in period of examination from Janualy to May 1987. We found the incidence of LN were in ML 18% (11/61) and in other disease patients 0.4% (4/1029). For the same period we examined 1029 cases of other disease without LN, including control group. We found that the ML with LN group had higher values for the aortomesenteric distance. The distance of the ML with LN group was 19±6 mm (control 9±6 mm, p≤0.01). The distance of the ML with LN group was larger than 10 mm. These cases were 48 percent of all ML cases in this study. The obesity ratio correlated positively with the aortomesenteric distance and angle. Obesity ratio gave a large influence on the distance. In the control group (obesity ratio +7%), 45% of the cases were larger than 10 mm, and in the ML without LN group (obesity ratio -1%), 24% of the cases were larger than 10 mm. Therefore we suggest a screening point is to be put on about 10 mm in ML cases. If the warning point is fixed at 16 mm (over mean+SD for control) in ML cases, sensitivity would be 94% and specificity would be 73%. When the distance is 16 mm or more, scanning must be performed carefully.