CT of chronic infiltrative lung disease: prevalence of mediastinal lymphadenopathy.
OBJECTIVE
Our goal was to determine the prevalence of mediastinal lymph node enlargement at CT in patients with diffuse infiltrative lung disease.


METHODS
The study was retrospective and included 175 consecutive patients with diffuse infiltrative lung diseases. Diagnoses included idiopathic pulmonary fibrosis (IPF) (n = 61), usual interstitial pneumonia associated with collagen vascular disease (CVD) (n = 20), idiopathic bronchiolitis obliterans organizing pneumonia (BOOP) (n = 22), extrinsic allergic alveolitis (EAA) (n = 17), and sarcoidosis (n = 55). Fifty-eight age-matched patients with CT of the chest performed for unrelated conditions served as controls. The presence, number, and sites of enlarged nodes (short axis > or = 10 mm in diameter) were recorded.


RESULTS
Enlarged mediastinal nodes were present in 118 of 175 patients (67%) with infiltrative lung disease and 3 of 58 controls (5%) (p <0.001). The prevalence of enlarged nodes was 84% (46 of 55) in sarcoidosis, 67% (41 of 61) in IPF, 70% (14 of 20) in CVD, 53% (9 of 17) in EAA, and 36% (8 of 22) in BOOP. The mean number of enlarged nodes was higher in sarcoidosis (mean 3.2) than in the other infiltrative diseases (mean 1.2) (p <0.001). Enlarged nodes were most commonly present in station 10R, followed by 7, 4R, and 5.


CONCLUSIONS
Patients with infiltrative lung disease frequently have enlarged mediastinal lymph nodes. However, in diseases other than sarcoid, usually only one or two nodes are enlarged and their maximal short axis diameter is <15 mm.
Niimi
H
H
Department of Radiology, University of British Columbia, Vancouver, Canada.
Kang
E Y
EY
Kwong
J S
JS
Carignan
S
S
Müller
N L
NL
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000542:Alveolitis, Extrinsic Allergic / Q000000981:diagnostic imaging; D001989:Bronchiolitis Obliterans / Q000000981:diagnostic imaging; D005260:Female; D006801:Humans; D008171:Lung Diseases / Q000000981:diagnostic imaging*; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008297:Male; D008482:Mediastinum; D008875:Middle Aged; D011014:Pneumonia / Q000000981:diagnostic imaging; D011658:Pulmonary Fibrosis / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012507:Sarcoidosis / Q000000981:diagnostic imaging; D014057:Tomography, X-Ray Computed