Reactive Mediastinal Lympadenopathy in Bronchiectasis Assessed by CT

1993 ◽  
Vol 34 (5) ◽  
pp. 489-491 ◽  
Author(s):  
R. D. Thomas ◽  
R. M. Blaquiere
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Mediastinal Lymph Node ◽  
Maximum Size ◽  
Mediastinal Lymphadenopathy ◽  
Mediastinal Lymph Nodes ◽  
Disease States ◽  
Size Number ◽  
Lymph Node Enlargement ◽  
Specific Finding

Mediastinal lymphadenopathy is commonly detected on CT. It is a non-specific finding, but because of its significance in the treatment in lung carcinoma it is important to know with which other disease states it is associated. We present a series of 42 patients in whom CT of the chest was used to confirm a clinical diagnosis of bronchiectasis. The size, number and distribution of mediastinal lymph nodes is documented. Lymph nodes were visible in 81% of patients. Nodes larger than 10 mm, the recognised maximum size for normal nodes in the U. K., were detected in 29%. In the absence of other recognised causes of lymphadenopathy in these patients, these findings confirm “reactive” mediastinal lymph node enlargement in bronchiectasis.

scholarly journals Mediastinal lymph node enlargement in idiopathic pulmonary fibrosis: relationships with disease progression and pulmonary function trends

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Giacomo Sgalla ◽  
Anna Rita Larici ◽  
Nicoletta Golfi ◽  
Mariarosaria Calvello ◽  
Alessandra Farchione ◽  
...  
Keyword(s):  
Lymph Node ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lymph Nodes ◽  
Ct Scan ◽  
Disease Progression ◽  
Mediastinal Lymph Node ◽  
Mediastinal Lymph Nodes ◽  
Lymph Node Enlargement

Abstract Background and objectives Evidence of mediastinal Lymph Node Enlargement (LNE) on CT scan is a common finding in idiopathic pulmonary fibrosis (IPF). We sought to investigate whether the involvement of mediastinal lymph nodes is associated with accelerated disease progression, and explored the changes occurring in mediastinal lymph nodes during the radiological follow up of these patients. Methods This retrospective study included IPF patients referred to a single ILD centre in Italy. A consensus-based assessment of mediastinal LNE on chest CT scan was performed by two thoracic radiologists. Kaplan-Meier curves and multivariate Cox proportional hazards regression were used to assess hazard ratios for mortality and disease progression (defined as categorical FVC decline ≥10%). The annualized rates of change in functional parameters for each patient were calculated using mixed linear models. Results The study population consisted of 152 IPF patients, of whom 135 (89%) received antifibrotic treatment for IPF during the study follow up. Patients having evidence of 3 or more enlarged mediastinal lymph nodes on baseline CT scan showed increased rates of mortality (HR 5.03, 95% CI 1.86–13.62, p ≤ 0.001) and significant disease progression (HR 2.99, 95% CI 1.22–7.33, p = 0.17) as compared to patients without LNE, after adjusting for GAP stage. Among 62 patients with LNE who underwent a follow up CT scan of the chest and received antifibrotic treatment, 57 (92%) maintained evidence mediastinal LNE over time. Conclusions Diffuse mediastinal lymph node involvement predicts clinically meaningful functional deterioration in patients with IPF.

scholarly journals Mediastinal lymph node enlargement in idiopathic pulmonary fibrosis: relationships with disease progression and pulmonary function trends.

2020 ◽  
Author(s):  
Giacomo Sgalla ◽  
Anna Rita Larici ◽  
Nicoletta Golfi ◽  
Mariarosaria Calvello ◽  
Alessandra Farchione ◽  
...  
Keyword(s):  
Lymph Node ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lymph Nodes ◽  
Ct Scan ◽  
Disease Progression ◽  
Mediastinal Lymph Node ◽  
Mediastinal Lymph Nodes ◽  
Lymph Node Enlargement

Abstract Background and objectivesEvidence of mediastinal Lymph Node Enlargement (LNE) on CT scan is a common finding in idiopathic pulmonary fibrosis (IPF). We sought to investigate whether the involvement of mediastinal lymph nodes is associated with accelerated disease progression, and explored the changes occurring in mediastinal lymph nodes during the radiological follow up of these patients.MethodsThis retrospective study included IPF patients referred to a single ILD centre in Italy. A consensus-based assessment of mediastinal LNE on chest CT scan was performed by two thoracic radiologists. Kaplan-Meier curves and multivariate Cox proportional hazards regression were used to assess hazard ratios for mortality and disease progression (defined as categorical FVC decline ≥10%). The annualized rates of change in functional parameters for each patient were calculated using mixed linear models.Results152 IPF patients were included in the analysis, of whom 135 (89%) received antifibrotic treatment for IPF during the study follow up. Patients having evidence of 3 or more enlarged mediastinal lymph nodes on baseline CT scan showed increased rates of mortality (HR 5.03, 95% CI 1.86-13.62, p≤0.001) and significant disease progression (HR 2.99, 95% CI 1.22-7.33, p=0.17) as compared to patients without LNE, after adjusting for GAP stage. Among 62 patients with LNE who underwent a follow up CT scan of the chest and received antifibrotic treatment, 57 (92%) maintained evidence mediastinal LNE over time.ConclusionsDiffuse mediastinal lymph node involvement predicts clinically meaningful functional deterioration in patients with IPF.

PS01.108: SPONTANEOUS ESOPHAGOCUTANEOUS FISTULA IN KIKUCHI DISEASE

2018 ◽  
Vol 31 (Supplement_1) ◽  
pp. 80-80
Author(s):  
Kelvin Voon ◽  
Mustafa Mohammed Taher ◽  
Reynu Rajan ◽  
Nik Ritza Kosai
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Mediastinal Lymph Node ◽  
Fistula Tract ◽  
Mediastinal Lymphadenopathy ◽  
Esophageal Fistula ◽  
Mediastinal Lymph Nodes ◽  
Transhiatal Approach ◽  
Laparoscopic Excision ◽  
Paraspinal Abscess

Abstract Background Kikuchi disease is a rare, self-limiting condition that is characterized by histiocytic necrotizing lymphadenitis with unknown pathogenesis. Common presentation is cervical lymphadenopathy and fever in a previously well young female. Mediastinal lymph node involvement is uncommon. Methods We report a case of spontaneous esophagocutaneous fistula secondary to necrotizing mediastinal lymphadenopathy in a patient with Kikuchi disease. Results A 38-year-old lady presented with fever and right back pain of two weeks duration. She had background history of Kikuchi disease which was diagnosed 1 year ago. Examination revealed multiple enlarged left cervical lymph nodes and right back tenderness. CT scan showed an esophagocutaneous fistula with right paraspinal abscess and multiple enlarged cervical and mediastinal lymph nodes. OGDS revealed a 5mm fistula opening at right posterior wall of distal esophageal, 3cm proximal to esophagogastric junction. Rest of esophagus and stomach were normal. Tuberculosis and SLE workup were negative. Cervical lymph node biopsy was consistent with Kikuchi disease. She was treated as spontaneous esophagocutaneous fistula secondary to necrotizing mediastinal lymph node with underlying Kikuchi disease. Percutaneous drainage of paraspinal abscess was done and antibiotics were commenced. Laparoscopic feeding jejunostomy was done for feeding. Esophageal stenting and endoscopic clipping of fistula were attempted but the fistula tract persisted. She then underwent laparoscopic excision of esophageal fistula tract (LEEFT). Intraoperative findings were dense inflamed paraesophageal tissue with thickened fistula tract at right posterolateral wall of distal esophagus with multiple enlarged mediastinal lymph nodes. Fistula tract and the lymph nodes were excised via laparoscopic transhiatal approach. She had an uneventful recovery and was discharged on post-operative day 7. Conclusion Spontaneous esophageal fistula is rare and necrotizing mediastinal lymphadenopathy needs to be considered. Laparoscopic excision of esophageal fistula tract (LEEFT) is a novel transhiatal approach and it is feasible in distally located fistula. Disclosure All authors have declared no conflicts of interest.

scholarly journals Mediastinal lymph node enlargement in idiopathic pulmonary fibrosis: relationships with disease progression and pulmonary function trends

2020 ◽  
Author(s):  
Giacomo Sgalla ◽  
Anna Rita Larici ◽  
Nicoletta Golfi ◽  
Mariarosaria Calvello ◽  
Alessandra Farchione ◽  
...  
Keyword(s):  
Lymph Node ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lymph Nodes ◽  
Ct Scan ◽  
Disease Progression ◽  
Mediastinal Lymph Node ◽  
Mediastinal Lymph Nodes ◽  
Lymph Node Enlargement

Abstract Background and objectives: Evidence of mediastinal Lymph Node Enlargement (LNE) on CT scan is a common finding in idiopathic pulmonary fibrosis (IPF). We sought to investigate whether the involvement of mediastinal lymph nodes is associated with accelerated disease progression, and explored the changes occurring in mediastinal lymph nodes during the radiological follow up of these patients. Methods: This retrospective study included IPF patients referred to a single ILD centre in Italy. A consensus-based assessment of mediastinal LNE on chest CT scan was performed by two thoracic radiologists. Kaplan-Meier curves and multivariate Cox proportional hazards regression were used to assess hazard ratios for mortality and disease progression (defined as categorical FVC decline ≥10%). The annualized rates of change in functional parameters for each patient were calculated using mixed linear models. Results: 152 IPF patients were included in the analysis, of whom 135 (89%) received antifibrotic treatment for IPF during the study follow up. Patients having evidence of 3 or more enlarged mediastinal lymph nodes on baseline CT scan showed increased rates of mortality (HR 5.03, 95% CI 1.86-13.62, p≤0.001) and significant disease progression (HR 2.99, 95% CI 1.22-7.33, p=0.17) as compared to patients without LNE, after adjusting for GAP stage. Among 62 patients with LNE who underwent a follow up CT scan of the chest and received antifibrotic treatment, 57 (92%) maintained evidence mediastinal LNE over time. Conclusions: Diffuse mediastinal lymph node involvement predicts clinically meaningful functional deterioration in patients with IPF.

scholarly journals The Diagnostic Yield of Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration (EBUS-TBNA) Technique in Assessment of Mediastinal Lymph Nodes

2021 ◽  
Author(s):  
Shahab Rafieian ◽  
Reza Ershadi ◽  
Hossein Ebrahimpoor ◽  
Matin Vahedi
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Diagnostic Yield ◽  
Mediastinal Lymph Node ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Mediastinal Lymphadenopathy ◽  
Mediastinal Lymph Nodes ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration

Abstract Background: Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) technique provides a complementary assessment of the areas of mediastinal lymph node involvement, and allows sampling of suspected lymph nodes. But, the usefulness of EBUS-TBNA in assessing all areas of mediastinal lymph nodes is little known and it seems that such assess is dependent to various factors related to the patient's condition and especially the characteristics of local lymph nodes. We aimed to evaluate the utility of EBUS-TBNA in assessing mediastinal lymph nodes and the factors associated with this utility.Methods: This cross-sectional study was performed on 40 patients suspected to mediastinal lymphadenopathy scheduled for assessment by EBUS-TBNA and mediastinoscopy. The diagnostic yield of EBUS-TBNA to mediastinal lymph nodes was evaluated and non diagnostic cases evaluated by mediastinoscopy .Results: In evaluation with EBUS-TBNA, the diagnostic yield of EBUS in assess to mediastinal lymph nodes including 34 out of 40 cases was equal to 85%. The size of lymph node (lower than 10mm), the area of sample (left and right upper paratracheal), and the nature of the lymph node sample (benign type) were associated with lower diagnostic yield for EBUS-TBNA.Conclusion: The diagnostic yield of EBUS in assessing mediastinal lymph nodes for sampling and diagnosis is 85%. This benefit is expected in the case of lesions larger than 10 mm, lesions of a malignant nature, as well as lesions in the inferior paratracheal and subcarinal stations.

scholarly journals Mediastinal tuberculosis in adult: case report

2017 ◽  
Vol 5 (5) ◽  
pp. 2246
Author(s):  
Gurminder Singh ◽  
Neeraj Joshi ◽  
Robin Garg ◽  
Sudhanshu Garg
Keyword(s):  
Lung Cancer ◽  
Case Report ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Mediastinal Lymph Node ◽  
Low Grade ◽  
Mediastinal Lymph Nodes ◽  
Adult Case ◽  
Lymph Node Enlargement

Mediastinal lymph node enlargement commonly seen in sarcoidosis, lung cancer, lymphoma and tuberculosis in children’s. Tuberculosis in adult mostly involve parenchyma of lung and very rarely involve mediastinal lymph nodes, here we report a 27-year-old male, non-diabetic, non-hypertensive, non-alcoholic and non-smoker who present with low grade fever and dry cough. Search for the cause of morbidity revealed him to be suffering from mediastinal tuberculosis. He was treated for tuberculosis with ATT.

scholarly journals Mediastinal lymph node enlargement in idiopathic pulmonary fibrosis: relationships with disease progression and pulmonary function trends

2020 ◽  
Author(s):  
Giacomo Sgalla ◽  
Anna Rita Larici ◽  
Nicoletta Golfi ◽  
Mariarosaria Calvello ◽  
Alessandra Farchione ◽  
...  
Keyword(s):  
Lymph Node ◽  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Lymph Nodes ◽  
Ct Scan ◽  
Disease Progression ◽  
Mediastinal Lymph Node ◽  
Mediastinal Lymph Nodes ◽  
Lymph Node Enlargement

Abstract Background and objectives Evidence of mediastinal Lymph Node Enlargement (LNE) on CT scan is a common finding in idiopathic pulmonary fibrosis (IPF). We sought to investigate whether the involvement of mediastinal lymph nodes is associated with accelerated disease progression, and explored the changes occurring in mediastinal lymph nodes during the radiological follow up of these patients. Methods This retrospective study included IPF patients referred to a single ILD centre in Italy. A consensus-based assessment of mediastinal LNE on chest CT scan was performed by two thoracic radiologists. Kaplan-Meier curves and multivariate Cox proportional hazards regression were used to assess hazard ratios for mortality and disease progression (defined as categorical FVC decline ≥10%). The annualized rates of change in functional parameters for each patient were calculated using mixed linear models. Results 152 IPF patients were included in the analysis, of whom 135 (89%) received antifibrotic treatment for IPF during the study follow up. Patients having evidence of 3 or more enlarged mediastinal lymph nodes on baseline CT scan showed increased rates of mortality (HR 5.03, 95% CI 1.86-13.62, p≤0.001) and significant disease progression (HR 2.99, 95% CI 1.22-7.33, p=0.17) as compared to patients without LNE, after adjusting for GAP stage. Among 62 patients with LNE who underwent a follow up CT scan of the chest and received antifibrotic treatment, 57 (92%) maintained evidence mediastinal LNE over time. Conclusions Diffuse mediastinal lymph node involvement predicts clinically meaningful functional deterioration in patients with IPF.

scholarly journals From Raw Pixels to Recurrence Image for Deep Learning of Benign and Malignant Mediastinal Lymph Nodes on Computed Tomography

2020 ◽  
Author(s):  
Tuan Pham
Keyword(s):  
Computed Tomography ◽  
Lung Cancer ◽  
Deep Learning ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Mediastinal Lymph Node ◽  
Survival Rates ◽  
Primary Lung Cancer ◽  
Lymph Node Status ◽  
Mediastinal Lymph Nodes

<div>Lung cancer causes the most cancer deaths worldwide and has one of the lowest five-year survival rates of all cancer types. It is reported that more than half of patients with lung cancer die within one year of being diagnosed. Because mediastinal lymph node status is the most important factor for the treatment and prognosis of lung cancer, the aim of this study is to improve the predictive value in assessing the computed tomography (CT) of mediastinal lymph-node malignancy in patients with primary lung cancer. This paper introduces a new method for creating pseudo-labeled images of CT regions of mediastinal lymph nodes by using the concept of recurrence analysis in nonlinear dynamics for the transfer learning. Pseudo-labeled images of original CT images are used as input into deep-learning models. Three popular pretrained convolutional neural networks (AlexNet, SqueezeNet, and DenseNet-201) were used for the implementation of the proposed concept for the classification of benign and malignant mediastinal lymph nodes using a public CT database. In comparison with the use of the original CT data, the results show the high performance of the transformed images for the task of classification. The proposed method has the potential for differentiating benign from malignant mediastinal lymph nodes on CT, and may provide a new way for studying lung cancer using radiology imaging. </div><div><br></div>

scholarly journals A Cause of Bilateral Chylothorax: A Case of Mesothelioma without Pleural Involvement during Initial Diagnosis

2015 ◽  
Vol 2015 ◽  
pp. 1-4 ◽  
Author(s):  
Ercan Kurtipek ◽  
Meryem İlkay Eren Karanis ◽  
Nuri Düzgün ◽  
Hıdır Esme ◽  
Mustafa Çaycı
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Malignant Mesothelioma ◽  
Mediastinal Lymph Node ◽  
Lymphatic Drainage ◽  
Initial Diagnosis ◽  
Mediastinal Lymph Nodes ◽  
Ductus Thoracicus ◽  
Bilateral Chylothorax ◽  
Pleural Involvement

Chylothorax is characterized by fluid accumulation in the pleural cavity containing chylomicrons due to disruption of lymphatic drainage in the thoracic ductus and development of chylothorax. A 60-year-old male patient presented to our clinic with shortness of breath and displayed bilateral pleural effusion and diffuse mediastinal lymph nodes in his computed chest tomography images. There were no thickening and nodular formation on the pleural surfaces. PET-CT showed no pathological FDG uptake. Thoracentesis showed a chylous effusion. Drainage reduced during monitoring could not be stopped; therefore, surgical intervention was considered. The patient underwent right thoracotomy. There were no pathological findings in the parietal and visceral pleura during the surgery. Initially lymphoma was considered. Perioperative samples were collected from the mediastinal lymph node. The pathology analysis reported metastasis of malignant mesothelioma. Evaluation of a repeated chest computed tomography showed nodular formations on the pleural surfaces. Mediastinal lymph nodes compressed the ductus thoracicus, resulting with chylothorax. The present case, with malignant mesothelioma, bilateral chylothorax, and mediastinal lymph node without any pleural involvement during initial diagnosis, is rare and will hence contribute to the literature.

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