Prevalence of Venoatrial Compression by Lymphadenopathy in Sarcoidosis.
OBJECTIVE
The purpose of the study was to evaluate the prevalence of compressive lymphadenopathy on pulmonary veins (PV) and left atrium (LA) in patients with sarcoidosis.


METHODS
A total of 101 consecutive patients underwent a chest computed tomography angiographic examination with specific analysis of: (a) 3 nodal stations (ie, 7, 8, and 9 stations) for detection of LA compression; (b) 2 nodal stations (ie, 10 and 11 right and left stations) for detection of PV compression.


RESULTS
Lymphadenopathy was present in 64 patients (64/101; 63.4%) with computed tomography features of venoatrial compression in 17 patients (17/101; 16.8%). This subgroup included 10 patients with LA compression alone (10/64; 15.6%), 6 patients with PV compression alone (6/64; 9.4%), and 1 patient with both (1/64; 1.5%). The mean diameter of enlarged lymph nodes compressing the LA and PVs was 3.18 ± 0.73 cm (range: 2.1 to 4.4 cm) and 1.9 ± 0.45 cm (range: 1 to 2.9 cm), respectively. PV compression was depicted in a total of 7 patients (7/101; 6.9%), observed as a unilateral (n = 5) or bilateral (n = 2) finding, with a mean number of 3.0 PVs compressed per patient (range: 1 to 7). A total of 10 venous sections showed features of compression, at the level of a lobar confluence (n = 6) or individual segmental veins (V6; n = 4), with a mean reduction in the venous cross-sectional area of 51.09% ± 12.85% (median: 50.06%). Nonfibrotic lung infiltration associated with sarcoidosis was observed in 88.2% of patients with compressive lymphadenopathy (15/17).


CONCLUSIONS
The prevalence of venoatrial compression in sarcoidosis is 16.8% in the studied population.
*Department of Thoracic Imaging, Hospital Calmette (EA 2694) †Department of Pulmonology, Centre of Rare Pulmonary Diseases ‡Department of Biostatistics (EA 2694), CHRU et Université de Lille 2 Nord de France, Lille, France.
Matthieu
M
Gomes
Sofiane
S
Bendaoud
Lidwine
L
Wemeau-Stervinou
Jean-Baptiste
JB
Faivre
Alain
A
Duhamel
Benoit
B
Wallaert
Jacques
J
Remy
Martine
M
Remy-Jardin
D000328:Adult; D000368:Aged; D005260:Female; D006325:Heart Atria / Q000000981:diagnostic imaging / Q000473:pathology; D006801:Humans; D008206:Lymphatic Diseases / Q000150:complications*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011667:Pulmonary Veins / Q000000981:diagnostic imaging* / Q000473:pathology*; D012507:Sarcoidosis / Q000150:complications*; D014057:Tomography, X-Ray Computed; D055815:Young Adult