Intrathoracic lymphadenopathy in patients with empyema

Linda B. Haramati, Daniel D. Alterman, Charles S. White, Andrew S. Kerr

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Purpose: Our goal was to determine the prevalence of intrathoracic lymphadenopathy on chest CT in patients with empyema. Method: We retrospectively identified 27 patients (14 men, 13 women, mean age 43 years) with nontuberculous empyema examined with chest CT. All scans were reviewed by two of three hoard-certified radiologists for the presence of intrathoracic lymphadenopathy (≤1 cm, short axis) in an American Thoracic Society (ATS) nodal station or the internal mammary region. Differences were resolved by consensus. Results: Thirteen (48%) patients with empyema had lymphadenopathy on chest CT. The mean number of enlarged lymph nodes for the patients with lymphadenopathy was 3.2 (SD ±2.3, range 1-8). The mean size of the largest lymph node was 1.4 cm (range 1.0-2.5 cm). The lymphadenopathy was unilateral and ipsilateral to the empyema in seven (54%), bilateral in five (38%), and unilateral contralateral to the empyema in one. The distribution of lymphadenopathy according to ATS nodal stations was 4R (n = 8), 7 (n = 6), 10R (n = 5); n = 2 each 2R, 10L, 11L; and n = 1 each 11R, 2L, 4L, and 6. Four patients had internal mammary lymphadenopathy. Pleural fluid and smooth pleural thickening were present in each case. Four patients had follow-up CT after treatment. There was a decrease or resolution of the lymphadenopathy in each case. Conclusion: Intrathoracic lymphadenopathy is a common CT finding in patients with empyema and occurred in 48% of this series. In patients with smooth pleural thickening and pleural effusion, intrathoracic lymphadenopathy should not be used as a criterion to differentiate empyema from malignant or tuberculous pleural effusion.

Original languageEnglish (US)
Pages (from-to)608-611
Number of pages4
JournalJournal of Computer Assisted Tomography
Volume21
Issue number4
DOIs
StatePublished - 1997

Fingerprint

Empyema
Thorax
Pleural Effusion
Breast
Lymph Nodes
Lymphadenopathy
Consensus

Keywords

  • Computed tomography
  • Empyema
  • Lungs, diseases
  • Lymph nodes, abnormalities
  • Thorax

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Intrathoracic lymphadenopathy in patients with empyema. / Haramati, Linda B.; Alterman, Daniel D.; White, Charles S.; Kerr, Andrew S.

In: Journal of Computer Assisted Tomography, Vol. 21, No. 4, 1997, p. 608-611.

Research output: Contribution to journalArticle

Haramati, Linda B. ; Alterman, Daniel D. ; White, Charles S. ; Kerr, Andrew S. / Intrathoracic lymphadenopathy in patients with empyema. In: Journal of Computer Assisted Tomography. 1997 ; Vol. 21, No. 4. pp. 608-611.
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abstract = "Purpose: Our goal was to determine the prevalence of intrathoracic lymphadenopathy on chest CT in patients with empyema. Method: We retrospectively identified 27 patients (14 men, 13 women, mean age 43 years) with nontuberculous empyema examined with chest CT. All scans were reviewed by two of three hoard-certified radiologists for the presence of intrathoracic lymphadenopathy (≤1 cm, short axis) in an American Thoracic Society (ATS) nodal station or the internal mammary region. Differences were resolved by consensus. Results: Thirteen (48{\%}) patients with empyema had lymphadenopathy on chest CT. The mean number of enlarged lymph nodes for the patients with lymphadenopathy was 3.2 (SD ±2.3, range 1-8). The mean size of the largest lymph node was 1.4 cm (range 1.0-2.5 cm). The lymphadenopathy was unilateral and ipsilateral to the empyema in seven (54{\%}), bilateral in five (38{\%}), and unilateral contralateral to the empyema in one. The distribution of lymphadenopathy according to ATS nodal stations was 4R (n = 8), 7 (n = 6), 10R (n = 5); n = 2 each 2R, 10L, 11L; and n = 1 each 11R, 2L, 4L, and 6. Four patients had internal mammary lymphadenopathy. Pleural fluid and smooth pleural thickening were present in each case. Four patients had follow-up CT after treatment. There was a decrease or resolution of the lymphadenopathy in each case. Conclusion: Intrathoracic lymphadenopathy is a common CT finding in patients with empyema and occurred in 48{\%} of this series. In patients with smooth pleural thickening and pleural effusion, intrathoracic lymphadenopathy should not be used as a criterion to differentiate empyema from malignant or tuberculous pleural effusion.",
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AB - Purpose: Our goal was to determine the prevalence of intrathoracic lymphadenopathy on chest CT in patients with empyema. Method: We retrospectively identified 27 patients (14 men, 13 women, mean age 43 years) with nontuberculous empyema examined with chest CT. All scans were reviewed by two of three hoard-certified radiologists for the presence of intrathoracic lymphadenopathy (≤1 cm, short axis) in an American Thoracic Society (ATS) nodal station or the internal mammary region. Differences were resolved by consensus. Results: Thirteen (48%) patients with empyema had lymphadenopathy on chest CT. The mean number of enlarged lymph nodes for the patients with lymphadenopathy was 3.2 (SD ±2.3, range 1-8). The mean size of the largest lymph node was 1.4 cm (range 1.0-2.5 cm). The lymphadenopathy was unilateral and ipsilateral to the empyema in seven (54%), bilateral in five (38%), and unilateral contralateral to the empyema in one. The distribution of lymphadenopathy according to ATS nodal stations was 4R (n = 8), 7 (n = 6), 10R (n = 5); n = 2 each 2R, 10L, 11L; and n = 1 each 11R, 2L, 4L, and 6. Four patients had internal mammary lymphadenopathy. Pleural fluid and smooth pleural thickening were present in each case. Four patients had follow-up CT after treatment. There was a decrease or resolution of the lymphadenopathy in each case. Conclusion: Intrathoracic lymphadenopathy is a common CT finding in patients with empyema and occurred in 48% of this series. In patients with smooth pleural thickening and pleural effusion, intrathoracic lymphadenopathy should not be used as a criterion to differentiate empyema from malignant or tuberculous pleural effusion.

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