Thin-Section CT Features of Intrapulmonary Lymph Nodes

Abstract

In current times, IPLNs are not uncommon lesions. We should consider IPLN in the differential diagnosis of solitary or multiple pulmonary nodules in the peripheral field and below the level of the carina. Thin-section CT showed precisely the border or relation between IPLNs and the surrounding structure. It was difficult to distinguish between IPLNs and malignant nodules from the degree of enhancement on contrast-enhanced CT. On thin-section and contrast-enhanced CT, the findings of IPLNs are not necessarily specific. Therefore, strict observation on CT is necessary; in certain cases that are increasing in size, video-assisted thoracic surgery should be considered because of their location.

Perifissural Nodules Seen at CT Screening for Lung Cancer

“…Nine subjects had died at the time of long-term follow-up. ( 24,25,27 ). In one study ( 27 ), 10 (53%) of 19 intrapulmonary lymph nodes were adjacent to the visceral pleura, with the remaining nine located 2-8 mm from the pleura.…”

“…These shape and location characteristics of PFNs suggest that they may represent intrapulmonary lymph nodes (23)(24)(25)(26)(27)(28). Previous authors using surgical confi rmation have noted that intrapulmonary lymph nodes are most frequently found in a subpleural location and inferior to the carina ( 23,24 ).…”

Resolving small pulmonary nodules: CT features

“…These are probably due to focal inflammatory lesions, mucoid impaction in small bronchi or intermittent enlargement of benign intrapulmonary lymph nodes [23][24][25]. In one screening trial for lung cancer, therefore, a course of antibiotics was administered in newly detected nodules and resolution of some nodules was observed after 4 weeks [12].…”

Pulmonary Perifissural Nodules on CT Scans: Rapid Growth Is Not a Predictor of Malignancy

“…Spherical nodules were also classified as non-PFN because a spherical shape suggests that the nodule is not influenced by the fissure, but is instead growing through the fissure. (7,(11)(12)(13), we defined a typical PFN as a fissure-attached, homogeneous, solid nodule that had smooth margins and an oval, lentiform, or triangular shape (Fig 2).…”

“…PFNs may represent lymph nodes (7); therefore, PFNs may show a growth rate similar to that of malignant nodules on follow-up CT scans. We hypothesized that the growth of PFNs is not a sign of malignancy and that growing PFNs will decrease in size on further follow-up CT images.…”