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Normal radiological lymph node appearance in the thorax.

T Hansen1, M Nilsson2, D Lindholm3

  • 1Department of Surgical Sciences.

Diseases of the Esophagus : Official Journal of the International Society for Diseases of the Esophagus
|December 19, 2018
PubMed
Summary
This summary is machine-generated.

This study describes normal lymph node appearance on CT scans in healthy adults aged 50-64. Men are more likely than women to have larger lymph nodes, impacting esophageal cancer staging.

Keywords:
cancer stagingcomputed tomography (CT)esophageal and gastric cancer

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Area of Science:

  • Radiology
  • Oncology
  • Anatomy

Background:

  • Accurate nodal staging is crucial for esophageal cancer treatment.
  • Normal lymph node appearance on computed tomography (CT) is not well-documented.
  • This information gap hinders precise clinical staging.

Purpose of the Study:

  • To characterize the appearance and size distribution of intrathoracic lymph nodes in a healthy adult population.
  • To establish reference ranges for lymph node size on CT scans relevant to esophageal cancer staging.
  • To identify demographic factors, such as sex and age, associated with lymph node size.

Main Methods:

  • Retrospective analysis of CT scans from 426 healthy individuals (aged 50-64) in the Swedish Cardiopulmonary bioimage study.
  • Detailed examination of intrathoracic lymph node stations pertinent to esophageal cancer staging.
  • Measurement of lymph node short axis, stratified by sex, with calculation of size distributions and proportions above 5mm and 10mm thresholds.
  • Logistic regression analysis to determine the probability of enlarged lymph nodes, adjusted for age and sex.

Main Results:

  • 72.5% of subjects had at least one lymph node with a short axis ≥5mm.
  • 6.81% of subjects had lymph nodes with a short axis ≥10mm.
  • Men showed significantly higher odds of having lymph nodes ≥5mm (OR 3.03) and ≥10mm (OR 2.31) compared to women.
  • Age was not significantly associated with lymph node size.
  • The subcarinal station (107) was the most frequent site for nodes ≥10mm.

Conclusions:

  • Normal intrathoracic lymph node size varies, with over half of healthy individuals aged 50-64 having nodes ≥5mm on CT.
  • Men are significantly more likely to exhibit larger lymph nodes (≥5mm and ≥10mm) than women.
  • These findings provide essential reference data for interpreting nodal status in esophageal cancer staging.
  • The subcarinal region is a common location for lymph nodes exceeding 10mm in this population.