What does there is extensive retroperitoneal lymphadenopathy with a periportal lymph node and the lymph nodes are not amenable for image guided sampling mean?

This is medical talk for a severe problem with the lymph nodes in the lower back. Periportal indicates that these lymph nodes are specifically those located near the portal vein near the liver. Not amenable for image guided sampling means that the patient must have extensive surgery to have a biopsy performed as imaging techniques will not be sufficient.