The present study demonstrates that enlarged mediastinal lymph nodes may occur in a rather high percentage of heavy smokers, especially in those with a MDCT finding of severe bronchitis.

Purpose: We demonstrate the multislice computed tomography (MSCT) findings of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)-proven hilar and mediastinal lymph node enlargement with signs of anthracosis. Materials and Methods: 53 enlarged lymph nodes in 39 patients (28 male, 11 female) with EBUS-TBNA-confirmed anthracosis were analyzed retrospectively. Results: The mean short axis diameter of the enlarged lymph nodes with signs of anthracosis was 13.7?mm. Lymph nodes most often showed an oval shape (84?%) and were well defined in 66?% of cases. Lymph node confluence was observed in 32?% of cases. Calcifications were documented in 24.5?% of cases. Contrast enhancement and fatty involution were seen seldom (3.8?%). Lymph node necrosis was not seen. Conclusion: Lymph node anthracosis may be found most often in enlarged, well defined lymph nodes with an oval shape, frequently associated with confluence and calcifications. Citation Format: ??Kirchner J, Mueller P, Broll M et?al. Chest CT Findings in EBUS-TBNA-Proven Anthracosis in Enlarged Mediastinal Lymph Nodes. Fortschr R?ntgenstr 2014; 186: 1122???1126

Objectives: Aim of this comparative study was to assess the accuracy of computed tomography (CT) and endobronchial ultrasound guided transbronchial needle aspiration (EBUS-TBNA) for mediastinal lymph node staging in cases of lymph node enlargement due to anthracosis and other benign conditions. Methods:In a retrospective analysis we report on the MSCT findings of 39 patients (28 males, 11 females) with EBUS-TBNA confirmed diagnosis of 53 enlarged lymph nodes due to anthracosis. A control group comprised 20 consecutive patients with 27 enlarged lymph nodes (11 males, 9 females) due to chronic lymphadenopathy (n = 14) or sarcoidosis (n = 13).Results: No significant differences were observed between the two groups regarding size (mean short axis diameter 13.7mm vs. 14.5mm), shape (most often oval) or presence of lymph node confluence (32.1% vs. 33.3%), contrast enhancement (3.8% vs. 3.7%), and fatty involution (3.8% vs. 3.7%). In comparison with the control group anthracotic lymph nodes were significantly less often ill-defined in EBUS (5.7 vs. 25.9, p = 0.025) as well as in CT (1.9% vs. 18.5%, p = 0.01), but more often showed calcifications in CT (24.5% vs. 3.7%, p = 0.017). Lymph node colliquation was seen neither in anthracosis nor in other benign conditions. Conclusions:Mediastinal lymph node enlargement due to anthracosis, lymphadenopathy and sarcoidosis show some different findings in EBUS and CT but cannot definitely be differentiated. Advances in knowledge:Radiologists should be aware of mediastinal lymph node enlargement due to anthracosis.

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