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The Egyptian Journal of Bronchology
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Role of multislice computed tomography in evaluation of thoracic lymphadenopathy

Egyptian Journal of Bronchology volume 8, pages 17–22 (2014)Cite this article

Abstract

Background

Mediastinal masses and lymphadenopathy are often incidentally detected on chest radiograph. Despite diagnostic limitations, the chest radiograph is also important for detecting and localizing mediastinal masses and lymphadenopathy when suspected clinically. Multislice computed tomography (CT) has transformed CT from a transaxial cross-sectional technique to a three-dimensional imaging modality.

Aim

The aim of this study was to assess the role of multislice CT in evaluation of thoracic lymphadenopathy (lymph node).

Patients and methods

The present study was conducted on 25 patients with thoracic lymphadenopathy on plain chest radiograph or clinically suspected with unremarkable chest radiograph recruited from the main university hospital of Alexandria. All patients were subjected to detailed history taking, full clinical examination, and conventional radiograph and multidetector CT of the chest with intravenous contrast, using four and six multidetector CT scanners, GE Lightspeed and Simens Emotion 6, respectively. The scan parameters used were 120 kVP and less than 240 mA per slice; tube rotation was 0.75 s and slice thickness was 1.25 mm. Fiberoptic bronchoscopy with transbronchial needle aspiration biopsy was performed according to radiological and bronchoscopic landmarks for cytological examination and histological examination.

Results

In this study, metastatic lymphadenopathy was encountered in nine patients, pulmonary tuberculosis in four, lymphoma in eight, and sarcoidosis in four. The diagnosis was confirmed by transbronchial needle aspiration biopsy and percutaneous needle aspiration from the peripheral lymph node.

Conclusion

Multislice CT of the chest is considered as a simple, safe, and minimally invasive procedure. Egypt J Broncho 2014 8:17–22

References

  1. Tecce PM, Fishman EK, Kuhlaman JE. CT evaluation of the anterior mediastinum: spectrum of disease. Radiographics 1994; 14:973–990.

    Article  CAS  Google Scholar 

  2. Priola SM, Priola AM, Cardinale L. The anterior mediastinum: anatomy and imaging procedures. Radiol Med 2006; 111:295–311.

    Article  CAS  Google Scholar 

  3. Lacasse Y, Martel S, Hebert A. Accuracy of virtual bronchoscopy to detect endobronchial lesions. Ann Thorac Surg 2004; 77:1774–1780.

    Article  Google Scholar 

  4. Muller NL. Advances in imaging. Eur Respir J 2001; 18:867–871.

    Article  CAS  Google Scholar 

  5. Prokop CS. In: Prokop M, Galanski M, editors. Image processing and displaying techniques. Spiral and multislice computed tomography of the body. New York: Thieme 2003. 45–83.

  6. Mountain CF, Dresler CM. Regional lymph node classification for lung cancer staging. Chest 1997; 111:1718–1723.

    Article  CAS  Google Scholar 

  7. Cymbalista M, Waysberg A, Zacharias C. CT demonstration of the 1996 AJCC-UICC regional lymph node classification for lung cancer staging. Radiographics 1999; 19:899–900.

    Article  CAS  Google Scholar 

  8. AU-Meltzer CC, Luketich JD, Friedman D. Diagnosis of mediastinal lymph node. Clin Nucl Med 2000; 25:882–887.

    Article  Google Scholar 

  9. Wang KP. Staging of bronchogenic carcinoma by bronchoscopy. Chest 1994; 106:588–593.

    Article  CAS  Google Scholar 

  10. Fultz PJ, Feins RH, Strang G. Detection and diagnosis of non-palpable supraclavicular lymph nodes in lung cancer at CT and US. Radiology 2002; 222:245–251.

    Article  Google Scholar 

  11. Lardinosis D, Weder W, Hany TF. Staging of non-small cell lung cancer with integrated positron-emission tomography and computed tomography. N Engl J Med 2003; 348:2500–2507.

    Article  Google Scholar 

  12. Silvestri GA, Gould MK, Margolis ML. Non-invasive staging of non-small cell lung cancer: ACCP evidenced-based clinical practice guidelines (2nd edition). Chest 2007; 132:178S–201S.

    Article  Google Scholar 

  13. Toma P, Granta C, Rossi A. Multimodality imaging of Hodgkin disease and non-Hodgkin lymphomas in children. Radiographics 2007; 27:1335–1354.

    Article  Google Scholar 

  14. Virginia AU, Leung AN. Radiologic manifestations of lymphoma in the thorax. Am J Roentgenol 1997; 168:93–98.

    Article  Google Scholar 

  15. Tateishi U, Müller NL, Johkoh T. Primary mediastinal lymphoma: characteristic features of the various histological subtypes on CT. J Comput Assist Tomogr 2004; 28:782–789.

    Article  Google Scholar 

  16. Koyama T, Ueda H, Togashi K. Radiologic manifestations of sarcoidosis in various organs. Radiographics 2004; 24:87–104.

    Article  Google Scholar 

  17. Akira M, Kozuka T, Inoue Y. Long-term follow-up CT scan evaluation in patients with pulmonary sarcoidosis. Chest 2005; 127:185–191.

    Article  Google Scholar 

  18. Prabhakar HB, Rabinowitz CB, Gibbons FK. Imaging features of sarcoidosis on MDCT, FDG PET, and PET/CT. Am J Roentgenol 2008; 190:S1–S6.

    Article  Google Scholar 

  19. Perez-Solis D, Luyando LH, Callejo-Ortea A. Disseminated tuberculosis. Radiology 2006; 238:366–370.

    Article  Google Scholar 

  20. Im JG, Itoh H, Shim YS. Pulmonary tuberculosis: CT findings in early active disease and sequential change with antituberculous therapy. Radiology 1993; 186:653–660.

    Article  CAS  Google Scholar 

  21. Moon WK, Im JG, Yeon KM. Mediastinal tuberculous lymphangitis: CT findings of active and inactive disease. Am J Roentgenol 1998; 170:715–718.

    Article  CAS  Google Scholar 

Download references

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Authors and Affiliations

  1. Department of Radiology, Alexandria, Egypt

    Adel Rezk, Sameh Hafez, Alaa Abd Al-Hamid & Mohamed Khamis

  2. Chest Diseases, Faculty of Medicine, Alexandria University, Alexandria, Egypt

    Ahmed Youssef Shaaban Gad MD

Authors
  1. Adel Rezk
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  2. Sameh Hafez
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  3. Alaa Abd Al-Hamid
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  4. Ahmed Youssef Shaaban Gad MD
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  5. Mohamed Khamis
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Corresponding author

Correspondence to Ahmed Youssef Shaaban Gad MD.

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Rezk, A., Hafez, S., Al-Hamid, A.A. et al. Role of multislice computed tomography in evaluation of thoracic lymphadenopathy. Egypt J Bronchol 8, 17–22 (2014). https://doi.org/10.4103/1687-8426.137347

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  • DOI: https://doi.org/10.4103/1687-8426.137347

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