Abstract
BackgroundMediastinal 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.AimThe aim of this study was to assess the role of multislice CT in evaluation of thoracic lymphadenopathy (lymph node).Patients and methodsThe 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.ResultsIn 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.ConclusionMultislice CT of the chest is considered as a simple, safe, and minimally invasive procedure. Egypt J Broncho 2014 8:17–22
Highlights
Mediastinal masses and lymphadenopathy are often incidentally detected on chest radiograph
In this study, metastatic lymphadenopathy was encountered in nine patients, pulmonary tuberculosis in four, lymphoma in eight, and sarcoidosis in four
Virginia et al [14] agreed with our results in that superior mediastinal lymphadenopathy is a hallmark of Hodgkin lymphoma (HL)
Summary
Mediastinal masses and lymphadenopathy are often incidentally detected on chest radiograph. Conventional radiography may detect or suggest the presence of mediastinal lesion, in most cases it is of limited use in determining the exact nature and extent of the lesion [1]. Because of this wide variety of anatomic structures, computed tomography (CT) enables accurate detection of lesions as well as precise demonstration of the relationship of such lesions with adjacent vital structures. The chest radiograph is 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 threedimensional imaging modality
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