title: Differentiation between tuberculosis and lymphoma in mediastinal lymph nodes: Evaluation with contrast-enhanced MDCT.
abstract: OBJECTIVE
  To determine the specific imaging criteria on contrast-enhanced multidetector computed tomography (MDCT) for differentiating between tuberculosis and lymphoma in mediastinal lymph nodes.
  
  
  METHODS
  The anatomical distribution and enhancement patterns of mediastinal lymph nodes on contrast-enhanced MDCT were reviewed in 37 patients with tuberculosis and 54 patients with lymphoma. Of the patients with lymphoma, 18 had Hodgkin's disease and 36 had non-Hodgkin's lymphoma.
  
  
  RESULTS
  Region 10R was involved more often in tuberculosis than in Hodgkin's disease and non-Hodgkin's lymphoma. Region 6 had a higher tendency to be affected in Hodgkin's disease and non-Hodgkin's lymphoma compared with tuberculosis. Tuberculosis showed peripheral enhancement in 78% of cases, frequently with a multilocular appearance, compared to Hodgkin's disease and non-Hodgkin's lymphoma, which showed peripheral enhancement in only 6 and 3% of cases, respectively. Homogeneous enhancement was more commonly seen in lymphoma (83% for Hodgkin's disease, and 83% for non-Hodgkin's lymphoma) than in tuberculosis (8%). In the determination of tuberculosis, results showed that when a peripheral enhancement pattern was seen, sensitivity was 78%, specificity was 96%, and accuracy was 89%. In the determination of lymphoma, results showed that when a homogeneous enhancement pattern was seen, sensitivity was 83%, specificity was 92%, and accuracy was 87%.
  
  
  CONCLUSIONS
  The findings of the present study indicate that specific anatomical distribution and enhancement patterns of lymphadenopathy shown on contrast-enhanced MDCT can be useful in differentiating tuberculosis from lymphoma of mediastinal lymph nodes.
authors.affiliation: Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China.
authors.forename: S-S
authors.initials: SS
authors.lastname: Tang
authors.forename: Z-G
authors.initials: ZG
authors.lastname: Yang
authors.forename: W
authors.initials: W
authors.lastname: Deng
authors.forename: H
authors.initials: H
authors.lastname: Shao
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.forename: L-Y
authors.initials: LY
authors.lastname: Wen
mesh_terms: D000293:Adolescent; D000328:Adult; D003287:Contrast Media; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007472:Iohexol; D008198:Lymph Nodes / Q000000981:diagnostic imaging; D008223:Lymphoma / Q000000981:diagnostic imaging*; D008297:Male; D008482:Mediastinum / Q000000981:diagnostic imaging*; D008875:Middle Aged; D061330:Multidetector Computed Tomography / Q000379:methods*; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014376:Tuberculosis / Q000000981:diagnostic imaging*; D055815:Young Adult
chemical_list: D003287:Contrast Media; D007472:Iohexol