Mediastinal lymph node staging by EBUS-TBNA and CT: Characteristics of lymph node enlargement caused by anthracosis and other benign conditions

Johannes Kirchner, Michael Broll, Philipp Müller, Esther Maria Kirchner, Natalia Pomjanski, Stefan Biesterfeld, Dieter Liermann, Ralph Kickuth

Abstract


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.

 


Full Text: PDF DOI: 10.5430/ijdi.v1n2p64

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International Journal of Diagnostic Imaging

ISSN 2331-5857 (Print)  ISSN 2331-5865 (Online)

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