scholarly journals Usefulness of lateral radiographs for detecting tuberculous lymphadenopathy in children – confirmation using sagittal CT reconstruction with multiplanar cross-referencing

2012 ◽  
Vol 16 (3) ◽  
pp. 87-92 ◽  
Author(s):  
Savvas Andronikou ◽  
Dirk Johannes Van der Merwe ◽  
Pierre Goussard ◽  
Robert P Gie ◽  
Nicolette Tomazos
Keyword(s):  
Lymph Node ◽  
Pulmonary Tuberculosis ◽  
Lymph Nodes ◽  
Sensitivity And Specificity ◽  
Chest Radiographs ◽  
Mediastinal Lymphadenopathy ◽  
Ct Reconstruction ◽  
Hilar Lymph Node ◽  
Specificity And Sensitivity ◽  
Lateral Chest

Background. Diagnosis of pulmonary tuberculosis (PTB) in children remains difficult. Lateral chest radiographs are frequently used to facilitate diagnosis, but interpretation is variable. In this study, lateral chest radiographs (CXRs) are evaluated against sagittal CT reconstructions for the detection of mediastinal lymphadenopathy. Aim. To correlate suspected lymphadenopathy on lateral CXR with sagittal CT reconstructions and determine which anatomical group of lymph nodes contributes to each lateral CXR location. Methods and materials. Thirty TB-positive children’s lateral CXRs were retrospectively reviewed for presence of mediastinal lymphadenopathy in 3 pre-determined locations in relation to the carina: retrocarinal, subcarinal and precarinal. Findings of the CT sagittal reconstructions were then correlated with the CXRs for the presence of lymphadenopathy in the same 3 pre-determined areas across the width of the mediastinum. Axial and coronal CT crossreferencing confirmed the position of the lymphadenopathy. Results. The most frequent locations for lymphadenopathy were the subcarinal (28) and right hilar (25). Sensitivity and specificity values of the CXRs were moderate, with the precarinal region having the best sensitivity and specificity for presence of lymphadenopathy. Contribution to each zonal group on lateral CXR were from multiple anatomical lymph node sites. Conclusion. The precarinal zone on CXR had the best specificity and sensitivity, and represented mainly subcarinal and right hilar lymph node groups. Attention should be paid to this area on lateral CXRs for detecting lymphadenopathy in children with suspected PTB.

scholarly journals Radiological Findings of Pulmonary Tuberculosis in Patients with and Without HIV Infections

2017 ◽  
Vol 16 (1) ◽  
Author(s):  
Radhiana binti Hassan ◽  
Haziq Hussaini bin Fauzi ◽  
Kamil Irsyad bin Yusoff ◽  
Muhammad Faizol bin Mohd Satar ◽  
Hafizah bt Pasi
Keyword(s):  
Pulmonary Tuberculosis ◽  
Chest Radiograph ◽  
Chest Radiographs ◽  
Mediastinal Lymphadenopathy ◽  
Hiv Positive ◽  
Sputum Smear ◽  
P Value ◽  
Radiological Findings ◽  
Radiological Manifestation ◽  
Hiv Negative

Introduction: Radiological manifestation of pulmonary tuberculosis in HIV positive patients is different with HIV negative patients. We aim to determine the differences in chest radiological findings of Pulmonary Tuberculosis among HIV and non-HIV infected patients in HTAA. Materials and method: A retrospective study was conducted in Chest Clinic, Hospital Tunku Ampuan Afzan, Kuantan Pahang. There were 101 chest radiographs with sputum smear-positive retrieved and reviewed. Socio-demographic status and chest radiographs findings were documented and analyzed. Results: Of the 101 patients, 12 patients were HIV positive. Of the 89 HIV negative patients, 96% had consolidation change on chest radiograph, in contrast with HIV positive patients, only 4% among them had this appearance and this is statistically significant (p value less than 0.05). Mediastinal lymphadenopathy is significantly higher (17%) in HIV positive patients compared to HIV negative patients (1%). Normal chest radiographs were more common in HIV positive patients (33%) as compared to HIV negative patients (2%). Conclusion: HIV positive patients with pulmonary tuberculosis exhibit different radiological manifestation on chest radiograph when compared to HIV negative patients.

Preoperative Staging of Large Primary Breast Cancer With [18F]Fluorodeoxyglucose Positron Emission Tomography/Computed Tomography Compared With Conventional Imaging Procedures

2008 ◽  
Vol 26 (29) ◽  
pp. 4746-4751 ◽  
Author(s):  
David Fuster ◽  
Joan Duch ◽  
Pilar Paredes ◽  
Martín Velasco ◽  
Montserrat Muñoz ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Lymph Node ◽  
Lymph Nodes ◽  
Sensitivity And Specificity ◽  
Primary Breast Cancer ◽  
Distant Metastases ◽  
Axillary Lymph Nodes ◽  
Axillary Lymph ◽  
Pet Ct ◽  
Large Primary

Purpose To evaluate the utility of positron emission tomography (PET) and [18F]fluorodeoxyglucose in the initial staging of large primary breast tumors. Patients and Methods This prospective study was approved by the ethics committee, and all patients gave their informed consent before enrollment. Sixty consecutive patients with large (> 3 cm) primary breast cancer diagnosed by clinical examination and breast magnetic resonance imaging (MRI) were entered onto the study. The mean age was 57 ± 13 years. Chest computed tomography (CT), liver ultrasonography, bone scan, and PET/CT were performed in all patients. All findings were histologically confirmed, and/or at least 1 year of follow-up was required. Correlation between parameters was calculated using Pearson's correlation coefficient. P < .05 was considered statistically significant. Results Primary tumor was identified by both PET/CT and MRI in all patients. Multifocal and/or multicentric tumors were found in 19 patients by MRI. Axillary lymph node metastases were found in 20 of 52 patients. Extra-axillary metastatic lymph nodes were also found in three patients. One patient showed an infiltrated lymph node in the contralateral axilla. The sensitivity and specificity for PET/CT to detect axillary lymph nodes metastases were 70% and 100%, respectively. PET/CT diagnosed all extra-axillary lymph nodes. The overall sensitivity and specificity of PET/CT in detecting distant metastases were 100% and 98%, respectively; whereas the sensitivity and specificity of conventional imaging were 60% and 83%, respectively. PET led to a change in the initial staging in 42% of patients. Conclusion PET/CT underestimates locoregional lymph node staging in large primary breast cancer patients. PET/CT is a valuable tool to discard unsuspected extra-axillary lymph nodes and distant metastases.

scholarly journals RADIONUCLIDE INDICATION OF SENTINEL LYMPH NODES IN LARYNX AND LARYNGOPHARYNX CANCER

2014 ◽  
Vol 13 (1) ◽  
pp. 116-121 ◽  
Author(s):  
I. G. Sinilkin ◽  
V. I. Chernov ◽  
Ye. L. Choinzonov ◽  
S. Yu. Chizhevskaya ◽  
A. A. Titskaya ◽  
...  
Keyword(s):  
Lymph Node ◽  
Sentinel Lymph Node ◽  
Lymph Nodes ◽  
Sensitivity And Specificity ◽  
Carotid Arteries ◽  
Radical Surgery ◽  
Sentinel Lymph Nodes ◽  
Node Dissection ◽  
Lower Jaw ◽  
Neck Lymph Nodes

Aim: to determine the possibility of radionuclide methods in the identification of "sentinel" lymph node (SLN) in larynx and laryngopharynx cancer patients.Material and methods: 17 patients with larynx and laryngopharynx cancer were included in research. In all patients for SLN visualization nanocolloid radiopharmaceutical was injection around tumor into mucous coat with the subsequent SPECT and radioguided study.Results: Sensitivity and specificity of SPECT and radioguided study for SLN identification were 100%. We found 22 SLN in 17 patients (from 1 to 2 per patient, on average 1.3). Most often SLN were located in the III level of a neck (lymph nodes around of carotid arteries) – 12 SLN (54.5%) and IIA level (under lower jaw lymph nodes) – 6 (27.2%). One SLN (4.5%) was localized in IV level and 3 nodes (13.6%) in VI level. In 2 patients (11.8%) metastasis in SLN were found. In these patients within 2 years cancer progressing was revealed. Fifteen patients (88.2%) had no metastatic in SLN and had no progressing of a cancer.Conclusions: Sensitivity and specificity of SPECT and radioguided study for SLN identification are 100%. In patients with metastatic SLN radical surgery with lymph node dissection is helpful.

scholarly journals Evaluation of Ultrasonography and Colour Doppler in Cervical Lymphadenopathy Taking Histopathology as Comparison

2021 ◽  
Vol 10 (19) ◽  
pp. 1391-1397
Author(s):  
Prinson George ◽  
Aria Jyothi Appukuttan
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Sensitivity And Specificity ◽  
Predictive Value ◽  
Imaging Modality ◽  
Cervical Lymphadenopathy ◽  
Colour Doppler ◽  
Likelihood Ratios ◽  
Cervical Lymph Nodes ◽  
Grey Scale

BACKGROUND Grey scale ultrasonography can be used as a first line imaging modality along with histopathology for evaluation of cervical lymphadenopathy. Morphologic features like size, shape, hilum and necrosis within the lymph node and vascularity are analysed. We wanted to identify the role of Grey scale ultrasonography and colour Doppler in characterisation of enlarged cervical lymph nodes, evaluate findings in benign and malignant cervical lymphadenopathy and assess the sensitivity, specificity, predictive value, likelihood ratios and accuracy in malignant and benign cervical lymph node enlargement. METHODS This was a cross sectional study with diagnostic test evaluation. All suspected cases of cervical lymphadenopathy referred for sonological evaluation to the Department of Radiodiagnosis of Govt. T.D. Medical College, Alappuzha were included in the study. About 75 patients included in the study, underwent Grey scale and colour Doppler sonography of cervical lymphadenopathy. RESULTS When three criteria were positive for malignancy, the sensitivity and specificity of grey scale ultrasonography and colour Doppler were 100 % and 73.80 %, and when four criteria were positive, the sensitivity and specificity were 72.73 %, and 90.48 % respectively. When we analysed individual variables, status of hilum (absence / presence) has reasonably good sensitivity and specificity, positive predictive value, negative predictive value and accuracy (90.09 %, 92.90 %, 90.09 %, 92.90 % and 92.0 % respectively). In our study the important criteria positive for malignant lymph nodes were size > / 11 mm in short axis diameter, round shape, absent hilum and peripheral and central + peripheral type of vascularity of cervical lymph nodes. For benign lymph nodes, oval shape, presence of hilum and central vascularity were the important criteria noted. CONCLUSIONS Grey scale ultrasonography can be complemented by colour Doppler ultrasonography (USG) in patients presenting with cervical lymphadenopathy to differentiate between benign and malignant lesions by reducing unnecessary biopsies by more accurate discrimination. KEY WORDS Grey Scale Ultrasonography, Malignant, Benign Lymph Nodes, Histopathology

scholarly journals EpCAM expression in lymph node and bone metastases of prostate carcinoma: A pilot study.

2014 ◽  
Vol 32 (4_suppl) ◽  
pp. 165-165
Author(s):  
Hilde Hoving ◽  
Karen Campos ◽  
Igle De Jong
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Bone Metastases ◽  
Sensitivity And Specificity ◽  
Prostate Carcinoma ◽  
Lymph Node Metastases ◽  
Hormonal Treatment ◽  
Clinicopathological Parameters ◽  
Epcam Expression ◽  
Node Metastases

165 Background: Correct staging of prostate carcinoma has huge treatment implications since metastasized prostate carcinoma cannot be treated curatively. Nowadays, skeletal scintigraphy is the mainstay for the assessment for bone metastases despite its poor sensitivity. Lymph node metastases can be diagnosed accurately with Computed Tomography. However, the gold standard is a pelvic lymph node dissection. A non-invasive diagnostic modality, that can assess both lymph node and bone metastases simultaneously, is preferred. In this retrospective pilot study expression of epithelial cell adhesion molecule (EpCAM) was investigated in lymph node metastases, normal lymph nodes, and bone metastases of prostate carcinoma. Furthermore, EpCAM expression was correlated to clinicopathological parameters. Methods: Lymph node metastases (n = 22) and matched normal lymph nodes (n = 22) were available in 17 patients who underwent a pelvic lymph node dissection because of suspicion of nodal involvement on CT. Bone metastases (n = 24) were available in 24 patients who underwent surgery to confirm the disease or to treat skeletal related events. Immunohistochemistry was performed to determine EpCAM expression. Two researchers, blinded to clinical data, scored the immunoreactivity according to Allred. Sensitivity and specificity of EpCAM immunoreactivity in lymph node and bone metastases was calculated. Fisher’s Exact Test was used to correlate EpCAM expression to the clinicopathological parameters Gleason score, prior radiotherapy and prior hormonal treatment. Results: Sensitivity and specificity of EpCAM expression was 100% in lymph nodes. In bone metastases sensitivity was 92%. No correlation between EpCAM expression and clinicopathological parameters was found. Conclusions: Molecular imaging of EpCAM is promising for prostate carcinoma staging, due to the high sensitivity and specificity in lymph node metastases and the high sensitivity in bone metastases. Even in poorly differentiated metastases and after hormonal treatment and radiotherapy, EpCAM was expressed.

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 Purulent Appearing Material in an Endobronchial Ultrasound-Guided Transbronchial Needle Aspiration of Mediastinal Lymph Node: A Diagnostic Challenge

2017 ◽  
Vol 2017 ◽  
pp. 1-5
Author(s):  
Damaris Pena ◽  
Gilda Diaz-Fuentes ◽  
Sindhaghatta Venkatram
Keyword(s):  
Lymph Node ◽  
Lymph Nodes ◽  
Malignant Tumors ◽  
Mediastinal Lymph Node ◽  
Lung Nodule ◽  
Needle Aspiration ◽  
Endobronchial Ultrasound ◽  
Mediastinal Lymphadenopathy ◽  
Ultrasound Guided ◽  
Transbronchial Needle Aspiration

Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has increasingly been performed for the diagnosis and staging of thoracic malignancies. Findings of a necrotic lymph node raise concern for infectious process and malignancy. A hypoechoic area on ultrasound/EBUS within a lymph node without blood flow is suggestive of pathologies like infections or malignancy. Inspection of the fluid could suggest a diagnosis; clear aspirates usually suggest bronchogenic or mediastinal cysts and purulent material suggests abscesses or necrotic lymph nodes. Growing tumor cells require a blood supply; if the vascular stroma is insufficient due to rapidly growing malignant tumors this could lead to large central areas of ischemic necrosis. Necrotic aspiration of lymph nodes is not always of infectious etiology. Aspiration of fluid in EBUS-TBNA is a rare occurrence, and malignancy should be considered when purulent fluid material is obtained. We present an elderly woman who underwent bronchoscopy with EBUS-TBNA for evaluation of upper lung nodule and mediastinal lymphadenopathy. Pus-like material was obtained on needle aspiration and endobronchial biopsy and mediastinal core biopsy revealed squamous cell carcinoma.

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.

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