Thoracic lymphadenopathy in benign diseases: A state of the art review

Abstract

Lymphadenopathy is a common radiological finding in many thoracic diseases and may be caused by a variety of infectious, inflammatory, and neoplastic conditions. This review aims to describe the patterns of mediastinal and hilar lymphadenopathy found in benign diseases in immunocompetent patients. Computed tomography is the method of choice for the evaluation of lymphadenopathy, as it is able to demonstrate increased size of individual nodes, abnormalities of the interface between the mediastinum and lung, invasion of surrounding fat, coalescence of adjacent nodes, obliteration of the mediastinal fat, and hypo- and hyperdensity in lymph nodes. Intravenous contrast enhancement may be needed to help distinguish nodes from vessels. The most frequent infections resulting in this finding are tuberculosis and fungal disease (particularly histoplasmosis and coccidioidomycosis). Sarcoidosis is a relatively frequent cause of lymphadenopathy in young adults, and can be distinguished from other diseases - especially when enlarged lymph nodes are found to be multiple and symmetrical. Other conditions discussed in this review are silicosis, drug reactions, amyloidosis, heart failure, Castleman's disease, viral infections, and chronic obstructive pulmonary disease.

Clinical usefulness of routine AFB culture and MTB PCR of EBUS‐TBNA needle rinse fluid

“…The most common site of extrapulmonary TB is the lymph nodes, including the intrathoracic lymph nodes . Unfortunately, diagnosis of intrathoracic tuberculous lymphadenitis is usually challenging because of the difficulty of the approach and the lack of specific clinical and radiologic characteristics; it often simulates malignancy or other inflammatory diseases …”

Differenzialdiagnose bei mediastinaler und hilärer Lymphadenopathie mit Fokus auf berufsbedingte Krankheitsbilder

“…Blastomykose [37,38]. Die exogen-allergische Alveolitis geht in der akuten Form mit einer typischen Symptomatik mit Dyspnoe, Hustenreiz, Fieber und thorakaler Beklemmung sowie allgemeinem Krankheitsgefühl mehrere Stunden nach Exposition einher [32].…”

The role of surgery in the diagnosis and the treatment of pulmonary tuberculosis

“…Unilateral compromise is usually presented, and hilar lymph nodes are most often affected. On CT, the most suggestive aspect of primary Tb consists of enlarged lymph nodes-generally >2 cm in diameter-with hypodense centers secondary to caseous necrosis, as well as a peripheral denser area that increases after the administration of contrast, representing a rim of granulomatous inflammatory tissue [12].…”