Impact of mediastinal lymph node enlargement on the prognosis of idiopathic pulmonary fibrosis

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.

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

10.21203/rs.3.rs-46826/v2 ◽

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.

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

10.21203/rs.3.rs-46826/v1 ◽

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.

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

10.21203/rs.3.rs-46826/v3 ◽

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.

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Diagnostic Yield of eXcelon, a New Transbronchial Histology Aspiration Needle in Patients With Mediastinal Lymph Node Enlargement

Journal of Bronchology ◽

10.1097/lbr.0b013e31803815c5 ◽

2007 ◽

Vol 14 (2) ◽

pp. 86-89 ◽

Cited By ~ 3

Author(s):

Frank H. W. Hermens ◽

Frederik B. J. M. Thunnissen ◽

Julius P. Janssen

Keyword(s):

Lymph Node ◽

Diagnostic Yield ◽

Mediastinal Lymph Node ◽

Lymph Node Enlargement

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Prognostic value of mediastinal lymph node enlargement in chronic interstitial lung disease

Diagnostic and Interventional Radiology ◽

10.5152/dir.2021.19585 ◽

2021 ◽

Author(s):

Stefano Grecuccio ◽

◽

Nicola Sverzellati ◽

Elisabetta Uslenghi ◽

Antonella Caminati ◽

...

Keyword(s):

Lymph Node ◽

Interstitial Lung Disease ◽

Lung Disease ◽

Prognostic Value ◽

Mediastinal Lymph Node ◽

Lymph Node Enlargement

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Tuberculous Lymphadenopathy Causing Dysphagia: Report of Two Cases

Asian Cardiovascular and Thoracic Annals ◽

10.1177/021849239800600313 ◽

1998 ◽

Vol 6 (3) ◽

pp. 208-211

Author(s):

Omer S Alamoudi ◽

Julio S Montaner ◽

Kenneth Evans ◽

J Mark FitzGerald

Keyword(s):

Mycobacterium Tuberculosis ◽

Lymph Node ◽

Mediastinal Lymph Node ◽

Hiv Positive ◽

Antituberculous Therapy ◽

First Line ◽

External Compression ◽

Lymph Node Enlargement

We report two cases of tuberculous lymphadenopathy causing dysphagia. The first patient was HIV positive and the second patient had immigrated recently from India. Culture in both patients grew Mycobacterium tuberculosis that was fully sensitive to first line drugs. Dysphagia may result from intrinsic or extrinsic involvement of the esophagus. Extrinsic involvement is more common and results from cervical and mediastinal lymph node enlargement (as in these 2 cases) that causes external compression on the wall of the esophagus. The dysphagia subsided completely after 4 weeks of antituberculous therapy in both cases.

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