Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentFrequently Asked Questions
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Frequently Asked Questions
Retroperitoneallymph nodesare located in the abdominal cavity. They can be found immediately behind the part of the intestine closer to your backbone than your belly button.
Not all causes of enlarged retroperitoneal lymph nodes are cancerous. In fact, in most cases, cancer is the last concern. Still, there are specific patterns of enlargement that require more extensive evaluation.
This article discusses the symptoms, causes, diagnosis, and treatment of enlarged lymph nodes.
Verywell / Gary Ferster
Symptoms of Enlarged Retroperitoneal Lymph Nodes
Unlike other types of lymph nodes, retroperitoneal lymph nodes generally cannot be felt or seen when enlarged. Because of this, doctors will often only discover an enlargement after an imaging scan of the abdomen and pelvis, such as a computed tomography (CT).
Some conditions that cause enlarged retroperitoneal lymph nodes may have associated symptoms. Specifically, people who have enlarged retroperitoneal lymph nodes related to lymphoma may also experience:
When retroperitoneal lymph nodes are enlarged due to metastatic cancer, symptoms might include:
Causes of Enlarged Retroperitoneal Lymph Nodes
Primary Causes
Oftentimes, lymph nodes in the abdomen become enlarged as a result of an infection.If the infection is confined to the abdomen, the enlarged lymph nodes will be found only in a small area. If it’s a systemic infection that involves the whole body, the enlarged lymph nodes will be more spread out.
Some of the causes of swollen retroperitoneal lymph nodes include:
Secondary Causes
More often than not, the cause of swollen retroperitoneal lymph nodes will be secondary. This means they happen because of a disease or disorder affecting an organ within or near the retroperitoneum. These include organs such as:
Sometimes a disease that affects one of these organs will also affect the associated lymph nodes and vice versa.
For instance, the ureters carry urine from the kidney to the bladder. Masses in this area can block a ureter, triggering inflammation and the production of inflammatorycytokines, which are molecules that play a role in the immune response. When this happens, retroperitoneal lymphadenopathy will almost always occur.
Cancers
Cancer is clearly the most concerning cause of retroperitoneal lymphadenopathy. Two of the most common malignancies associated with this arelymphomaandtesticular cancer.
Lymphoma
Lymphomas are a group of cancers that are consideredlymphoproliferative. This means they cause excessive production of white blood cells calledlymphocytes. Lymphomas usually start in the lymph nodes, typically the retroperitoneal lymph nodes. There are two main categories of lymphoma:
Testicular Cancer
Cancers can often spread from a primary tumor to retroperitoneal lymph nodes.One such cancer istesticular cancer.
Diagnosis of Enlarged Retroperitoneal Lymph Nodes
Certain patterns of enlargement are worrisome. For example, a large mass of lymph nodes that appears stuck together on an imaging scan may be a sign ofmetastatic cancer.
In instances like these, your healthcare provider may recommend additional tests such as:
A CT scan may also provide other indications of the potential cause. For example, if both the liver and spleen are enlarged along with the retroperitoneal lymph nodes, this may be a sign of lymphoma.
With HL, the pattern of enlargement typically moves from one lymph node group to the next. With NHL, the distribution is more scattered. It may involve distant lymph nodes and organ systems, primarily the gastrointestinal tract.
Treatment of Enlarged Retroperitoneal Lymph Nodes
Treatment of enlarged lymph nodes in the abdomen usually involves treating the underlying cause. For example, tuberculosis is typically treated with a combination of antibiotics.
Retroperitoneal lymph nodes can be removed if the cause of the enlargement is metastatic cancer. This is done during an operation called a retroperitoneal lymph node dissection (RPLND).
During RPLND, the retroperitoneal lymph nodes are removed through an incision in the abdomen. The procedure is done under general anesthesia, which means you will be in a sleep-like state. It usually takes 3.5 to 5 hours.
Summary
To treat enlarged retroperitoneal lymph nodes, healthcare providers typically treat the underlying cause.
Sometimes enlarged retroperitoneal lymph nodes happen when cancer spreads from another part of the body. This is a less common cause of this condition.
ForHodgkin’s lymphoma, the five-year survival rates are:
Fornon-Hodgkin’s lymphoma, depending on whether it’s follicular lymphoma or diffuse large B-cell lymphoma, the rates are:
Learn MoreWhat Does Cancer Survival Rate Mean?
Yes, retroperitoneal lymph nodes can be removed, and this is often used as a treatment option for testicular cancer. It can also be used to diagnose stages of cancer. The procedure is called a retroperitoneal lymph node dissection.
How Lymphadenopathy Is Diagnosed
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