J Korean Radiol Soc.  1988 Oct;24(5):767-774. 10.3348/jkrs.1988.24.5.767.

An analysis of CT findings of mediastinal lymphadenopathy

• Park JM
• Im JG
• Hong JH
• Han MC

• KMID: 2359210
• DOI: http://doi.org/10.3348/jkrs.1988.24.5.767

Abstract

CT plays an important role in evaluating mediastinal lymphadenopathy, especially in the staging of lung cancer. However, its role has been confined to the detectibitlity of pathologic lymph nodes by using the sizecriteria. Still seldom effort has been made on morphologic analysis of the disased lymph nodes. We analyzed post-enhance CT scans of 64 pathologically proven pateints who had mediastinal lymphadenopathy, with special reference to nodal architecture. 24 of the 41 patients with lung cancer and 15 of the 17 pateints with tuberculous mediastinal lymphadenitis showed intranodal necrotic low denstiy. Not only tuberculous lymph nodes showed higher incidence but also showed higher conspicuity of the necrotic low density than that of the metastatic nodes fromlung cancer. Conspicuity of internal low denstiy in tuberculous nodes was due to significantly higher denstiy ofenhcaned rim (121.7±18.7 HU) than that of metastatic nodes(91.2±23.4HU) (p<0.01). As the node size increasesincidences of necrotic low density increased both in tuberculous and metastatic nodesm, but the latter steeper.Analysis of the location of the diseased node did not show any significant difference between tuberculous and metastatic nodes. If there is coexistence of primary lung mass, the possibility of lung canaer was markedly elevated than that of tuberculosis and the internal low density in lung mass shows some tendency of coexistence ofcentral low density within metastatic lymph nodes.

MeSH Terms

Humans
Incidence
Lung
Lung Neoplasms
Lymph Nodes
Lymphadenitis
Lymphatic Diseases*
Tomography, X-Ray Computed
Tuberculosis