Lymphomas of Mediastinum: Postprocessing of Tomographic Images

Abstract

The syndrome of lymphadenopathy (lymph-node hyperplasia) takes place in many diseases that are different by etiology, clinical course, methods of treatment and prediction. While identifying the cause of lymphadenopathy the diagnostic search should be based on the clinical situation (the character of lymphadenopathy, the presence of other symptoms, anamnestic data, the character of changes in the peripheral blood and others). The choice of the most informative method of diagnosis is defined by the diagnostic hypothesis with the consideration of the data of the primary examination of the patient, the parameters of the peripheral blood as well as the values of sensitivity and specificity of the corresponding method of study for verification of the disease supposed. The basis of this research was the material of computed-tomography examination of chest organs in 491 patients with different forms of mediastinum lymphomas in the consultative policlinic of the Far-Eastern Scientific Center of Physiology and Pathology of Respiration from 2011 till 2017. Among them there were sarcoidosis of intrathoracic lymph glands of the first, second and partially third stage (n=432); Hodgkin's lymphoma (n=17); metastases in lymph glands of mediastinum (n=25); lymphosarcoma (n=12), tuberculosis of lymph glands in adults (n=5). Beside prevailing digital radiologic studies, multispiral computed tomography was done to all of them and 78% went through fiberbronchoscopy. The verification was in 82% of patients: transbronchial biopsy under ultrasound visualization (72%) and transthoracic open biopsy (28%).