title: Poststernotomy lymphadenopathy: prevalence, size, and location on chest CT.
abstract: OBJECTIVE
  We aimed to determine the prevalence of enlarged lymph nodes (LNs) in chest computed tomography (CT) scans of patients with a history of sternotomy.
  
  
  METHODS
  The chest CT scans of 271 patients with a history of sternotomy (mean age, 68.3±14.4 years; range, 15-93 years; 178 males) were retrospectively scored in a blind and random manner for the presence, size, and location of enlarged LNs. Scans with known etiologies for enlarged LNs were excluded. Serial scans were available for 15 patients with enlarged LNs. Twenty patients (mean age, 61.2±7.0 years; range, 54-64 years; 15 males) that had cardiac CT data with no cardiac surgery were included as controls.
  
  
  RESULTS
  Of the 271 patients, 189 had other identifiable etiologies for enlarged LNs. Of the remaining 82 patients, 36 (44%) demonstrated enlarged LNs. None of the control patients presented with enlarged LNs (n=20). The mean size of the enlarged nodes was 13.0±2.0 mm. Enlargement of the lymph nodes in station 4R was most common (n=18, 50%; size, 13.1±2.0 mm), followed by the enlargement of nodes in station 7 (n=16, 44%; size, 12.3±2.2 mm). The majority of patients had one (n=20, 56%) or two (n=12, 33%) nodal stations that showed enlargement. We did not observe any significant association between the number or types of grafts and enlarged LNs. Serial CT scans did not show any significant changes in LN enlargement for any nodal station.
  
  
  CONCLUSIONS
  Enlarged mediastinal and/or hilar LNs are common in patients with a history of previous sternotomy. It is important for radiologists to be aware of this association to avoid misdiagnosis and further unnecessary procedures for nodal sampling.
authors.affiliation: Department of Radiology, St. Vincent's University Hospital, Dublin, Ireland.
authors.forename: Colin J
authors.initials: CJ
authors.lastname: McCarthy
authors.forename: Ailbhe C
authors.initials: AC
authors.lastname: O'Neill
authors.forename: Sinead H
authors.initials: SH
authors.lastname: McEvoy
authors.forename: Aoife
authors.initials: A
authors.lastname: Kilcoyne
authors.forename: Marcus W
authors.initials: MW
authors.lastname: Butler
authors.forename: Michael P
authors.initials: MP
authors.lastname: Keane
authors.forename: Jonathan D
authors.initials: JD
authors.lastname: Dodd
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D008198:Lymph Nodes / Q000000981:diagnostic imaging*; D008206:Lymphatic Diseases / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D015995:Prevalence; D011856:Radiographic Image Enhancement / Q000379:methods; D013902:Radiography, Thoracic / Q000379:methods*; D012189:Retrospective Studies; D056346:Sternotomy; D014057:Tomography, X-Ray Computed / Q000379:methods*; D055815:Young Adult
chemical_list: D003287:Contrast Media