Internal thoracic lymphadenopathy and pulmonary tuberculosis

Area of Science:

• Radiology
• Pulmonology
• Infectious Diseases

Background:

• Internal thoracic lymphadenopathy (ITL) is recognized in malignancies and non-tuberculous empyema.
• The association between ITL and active pulmonary tuberculosis (PTB) remains underexplored.
• Correlation of ITL with other active PTB imaging findings is not well-established.

Purpose of the Study:

• To investigate the prevalence of ITL in adult patients with active PTB.
• To determine the correlation between ITL and various imaging characteristics of active PTB.
• To assess the significance of ITL in the differential diagnosis of active PTB.

Main Methods:

• Retrospective cohort study of 137 adults with active PTB and chest CT scans.
• Evaluation of ITL and nine other imaging features by two thoracic radiologists.
• Statistical analysis using Wilcoxon rank-sum and chi-squared tests to assess correlations.

Main Results:

• ITL was identified in 36.5% of active PTB cases, frequently bilateral or right-sided.
• Significant correlations were found between ITL and pleural effusion, mediastinal lymphadenopathy, and empyema (p<0.0001).

Conclusions:

• Active PTB should be considered in the differential diagnosis of ITL, especially when other imaging findings like pleural effusion are present.
• Radiologists should consider active PTB alongside malignancy when encountering ITL in appropriate clinical contexts.