Detection and follow-up of mediastinal lymph node enlargement in tuberculous pericardial effusions using computed tomography

CT Findings in Patients With Pericardial Effusion: Differentiation of Malignant and Benign Disease

“…More important, mediastinal lymph node enlargement also was a significant finding of malignant pericardial effusion in patients with malignant disease. In the literature [28,29], mediastinal lymph node enlargement has been associated with tuberculous pericarditis. However, among nine cases of tuberculous pericarditis in our study, only two cases (22.2%) manifested mediastinal lymph enlargement.…”

Diagnosis of tuberculous aetiology in pericardial effusions

“…12 Normal mediastinal lymph nodes are ,10 mm and do not change in size on follow up. 38 39 Enlarged mediastinal lymph nodes .10 mm detected on chest computed tomography have been reported recently (figs 3 and 4) and for the first time in virtually 100% of patients with TPE.…”

“…The mediastinal node enlargement in TPE does not show up on routine chest radiographs (fig 1) but can be seen only on chest computed tomography or magnetic resonance imaging (MRI) studies. 12 In other conditions associated with pericardial effusion and mediastinal adenopathy like lymphomas, malignancy, and sarcoid hilar node involvement is prominent even though in sarcoidosis the pericardium is involved in fewer than 3% of patients. 19 …”

“…33 34 Chest computed tomography Recent observations on chest computed tomography regarding the detection of mediastinal lymph nodes in TPE and their value in diagnosis of TPE are discussed later. 12 Computed tomography also allows study of the pericardium and the pleural changes (fig 2).…”

“…1 7 12 15 Pericardial rub is present in (37%-84%) 1 7 and rarely can even be triphasic. 12 Raised jugular venous pressure is frequent and pulsus paradoxus is present in (23%-71%) with tamponade (box 1). 15 Peripheral lymphadenopathy with matting which most often affects the cervical glands has been reported in 13%-28% with TPE 1 and biopsy of the gland is diagnostic.…”