Upper Abdominal Lymph Nodes: Criteria for Normal Size Determined with CT

Reports of the upper limits of normal for lymph node size at abdominal computed tomography have varied from 6 to 20 mm. Establishment of an upper limit for node size by specific location, analogous to that which has been reported for mediastinal lymph nodes, was sought. Short-axis diameters of the lymph nodes were measured in 130 patients who were not likely to have enlarged abdominal lymph nodes. Seven locations were defined, and the largest nodal measurement for each was recorded. Histographic analysis and nonparametric statistical methods were used to determine threshold values for the maximum node size in each region. The upper limits of normal by location were as follows: retrocrural space, 6 mm; paracardiac, 8 mm; gastrohepatic ligament, 8 mm; upper paraaortic region, 9 mm; portacaval space, 10 mm; porta hepatis, 7 mm; and lower paraaortic region, 11 mm. Lower paraaortic lymph nodes larger than 11 mm by short-axis measurement are abnormal. In other locations, nodes smaller than 1 cm may be abnormal if the determined thresholds are exceeded.