CT of Chronic Infiltrative Lung Disease: Prevalence of Mediastinal Lymphadenopathy

Niimi, Hiroshi; Kang, Eunyoung; Kwong, Justin; Carignan, Stéphane; Müller, Néstor L.

doi:10.1097/00004728-199603000-00026

Cited by 75 publications

(41 citation statements)

References 9 publications

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“…Intensity discriminant Intensity discriminant The presence of enlarged lymph nodes in HP was previously described for acute and subacute HP [21]. In this study the presence of enlarged lymph nodes in subjects with a history of HP with no current clinically active disease suggests that the presence of mediastinal adenopathy may not be a reliable finding to rule out HP or a history of the disease or differentiate it from sarcoidosis or other clinical entities associated with enlarged mediastinal lymph nodes.…”

Section: Discussionmentioning

confidence: 83%

High-resolution computed tomographic characteristics in acute farmer's lung and in its follow-up

et al. 2000

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High resolution computed tomography (HRCT) scans are increasingly used in hypersensitivity pneumonitis (HP). This study looked at HRCT findings at different phases of farmer's lung (FL), a common form of HP.A cross sectional analysis of 95 HRCT scans of FL cases (20 acute, 75 with a history of FL, 48 still in contact (Ex +) (dairy farm), and 27 who had ceased contact (Ex-)) was made. All scans were read independently by two, and if needed by three, radiologists blinded to the category. The lungs were divided into six regions (fives lobes + lingula), and read for attenuation/mosaic, ground-glass, micronodules, fibrosis, and emphysema. A score of 0±3 was given for each region and each variable: 0 = absence, 1 =<25% of the surface, 2 = 25±50%, 3 =>50%. Mediastinal lymphadenopathy was also noted.Ground glass, predominating in the lower lobes, was the most frequent feature in the acute and Ex+ cases. Other abnormalities had no preferential distribution. Ex+ had more ground-glass than the Ex-(p=0.0025). Emphysema was more frequently seen than interstitial fibrosis (p=0.004). Mediastinal lymphadenopathy was present in 26 cases (9 acute, 10 Ex+ and 7 Ex-).In conclusion, in farmer's lung: 1) ground-glass predominates in the lower lobes while the other abnormalities have no anatomic predilection; 2) contact avoidance allows a better resolution of computed tomography abnormalities than continued exposure; 3) emphysema is a more frequent finding than interstitial fibrosis; and 4) the presence of mediastinal lymphadenopathy has no negative diagnostic value. Eur Respir J 2000; 16: 56±60.

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Section: Discussionmentioning

confidence: 83%

High-resolution computed tomographic characteristics in acute farmer's lung and in its follow-up

et al. 2000

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“…Overall, hilar or mediastinal lymphadenopathy are encountered on CT in 47-94% of patients with sarcoidosis, irrespective of radiographic staging [35,42,[57][58][59][60]. Lymph nodes are usually bilateral but with right-sided predominance [57][58][59][60]. In two studies based on the American Thoracic Society lymph node map, the most commonly involved nodal stations, in decreasing order of frequency, were: 4R (right lower paratracheal); 10R (right hilar); 7 (sub-carinal); 5 (sub-aortic, i.e.…”

Section: Thoracic Lymphadenopathymentioning

confidence: 99%

“…In two studies based on the American Thoracic Society lymph node map, the most commonly involved nodal stations, in decreasing order of frequency, were: 4R (right lower paratracheal); 10R (right hilar); 7 (sub-carinal); 5 (sub-aortic, i.e. aorto-pulmonic window); 11R (right interlobar); and 11 L (left interlobar) [59,60]. A median of three lymph nodes were enlarged, as defined by a maximum short-axis diameter o10 mm, and diameter was o20 mm in 29.1% of cases [59].…”

Section: Thoracic Lymphadenopathymentioning

confidence: 99%

“…aorto-pulmonic window); 11R (right interlobar); and 11 L (left interlobar) [59,60]. A median of three lymph nodes were enlarged, as defined by a maximum short-axis diameter o10 mm, and diameter was o20 mm in 29.1% of cases [59]. Lymphadenopathy is also common in collagen vascular disease (present in 70% of cases), idiopathic pulmonary fibrosis (IPF) (67%), extrinsic allergic alveolitis (53%) and organising pneumonia (36%) [59].…”

Section: Thoracic Lymphadenopathymentioning

confidence: 99%

“…A median of three lymph nodes were enlarged, as defined by a maximum short-axis diameter o10 mm, and diameter was o20 mm in 29.1% of cases [59]. Lymphadenopathy is also common in collagen vascular disease (present in 70% of cases), idiopathic pulmonary fibrosis (IPF) (67%), extrinsic allergic alveolitis (53%) and organising pneumonia (36%) [59]. However, the number of enlarged lymph nodes is higher in sarcoidosis and a size greater than 20 mm in short-axis diameter increases the chance of sarcoidosis [59].…”

Section: Thoracic Lymphadenopathymentioning

confidence: 99%

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Imaging of sarcoidosis of the airways and lung parenchyma and correlation with lung function

et al. 2012

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Imaging has a prominent role in the assessment of sarcoidosis diagnosis and outcome, which are extremely variable. Chest radiography staging helps predict the probability of spontaneous remission, and stage IV is associated with higher mortality. However, the reproducibility of reading is poor and changes in radiography and lung function are inconsistently correlated, which may be problematic for the monitoring of disease and treatment response. Chest computed tomography (CT) makes a great diagnostic contribution in difficult cases. Bilateral hilar lymphadenopathy with peri-lymphatic micronodular pattern is highly specific for sarcoidosis. CT is important for the investigation of pulmonary complications, including aspergilloma and pulmonary hypertension. CT improves the yield of bronchoscopy for obtaining a positive endobronchial or transbronchial biopsy. CT findings may also discriminate between active inflammation and irreversible fibrosis, with occasional influence on therapeutic decisions. Three CT patterns of fibrotic sarcoidosis are identified, with different functional profiles: predominant bronchial distortion is associated with obstruction; honeycombing is associated with restriction and lower diffusing capacity of the lung for carbon monoxide; whereas functional impairment is relatively minor with linear pattern. The clinical impact of correlations between CT severity scores and functional impairment is uncertain, except for its utility elucidating the mechanisms of airflow limitation, which include bronchial distortion, peribronchovascular thickening, air-trapping and bronchial compression by lymphadenopathy.

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Sarcoidosis

Lynch¹,

Kazerooni²

2001

Radiologic Diagnosis of Chest Disease

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CT of Chronic Infiltrative Lung Disease: Prevalence of Mediastinal Lymphadenopathy

Abstract: Patients with infiltrative lung disease frequently have enlarged mediastinal lymph nodes. However, in diseases other than sarcoid, usually only one or two nodes are enlarged and their maximal short axis diameter is <15 mm.

Cited by 75 publications

References 9 publications

High-resolution computed tomographic characteristics in acute farmer's lung and in its follow-up

High-resolution computed tomographic characteristics in acute farmer's lung and in its follow-up

Imaging of sarcoidosis of the airways and lung parenchyma and correlation with lung function

Sarcoidosis

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