Insidious onset back ache. Ultrasound revealed multiple abdominal lymph nodes.
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Multiple enlarged discrete lymph nodes are seen in porta hepatis, celiac axis, mesenteric root, para aortic, aortocaval and paracaval stations. They enhance mildly, appear to encase vessels without much displacement. Preserved perilymph node fat planes. No other abdominal solid visceral lesions.
Insidious onset back ache is the typical presentation of Non-Hodgkin lymphoma in a young patient. Ultrasound initially picks up the abdominal lymphadenopathy which is later on confirmed with a contrast enhanced CT scan and biopsy. The typical non invasive nature of lymph node growth distinguishes it from other neoplastic etiologies.