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Paracardiac adenopathy: CT evaluation.

S K Sussman, R A Halvorsen, P M Silverman

    AJR. American Journal of Roentgenology
    |July 1, 1987
    PubMed
    Summary
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    Normal paracardiac lymph nodes are typically small and few. Enlarged paracardiac nodes on CT scans can indicate lymphoma or other serious conditions, necessitating further investigation.

    Area of Science:

    • Radiology
    • Oncology
    • Pathology

    Background:

    • The normal appearance of paracardiac lymph nodes on computed tomography (CT) is not well-established.
    • Accurate characterization of paracardiac lymphadenopathy is crucial for diagnosis and management.

    Purpose of the Study:

    • To define the normal CT appearance of paracardiac lymph nodes.
    • To differentiate between benign, lymphomatous, and other malignant causes of paracardiac adenopathy.

    Main Methods:

    • Retrospective review of CT scans from 50 patients without known malignancy or lymphadenopathy.
    • Evaluation of CT findings in 45 patients with confirmed paracardiac adenopathy.
    • Comparison of CT findings with chest radiographs in 38 patients.

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    Main Results:

    • Normal paracardiac lymph nodes measured up to 3.5 mm, with a maximum of two nodes observed.
    • The upper limit for normal paracardiac lymph node diameter was suggested as 1 cm.
    • Lymphoma accounted for 40% of paracardiac adenopathy; other causes included carcinoma, sarcoma, and benign diseases.
    • Features suggestive of lymphoma included bilateral involvement, multiple nodes >2 cm, lobulated appearance, and pericardial effusion/thickening.
    • Chest radiographs were significantly less sensitive than CT in detecting paracardiac lymph node enlargement.

    Conclusions:

    • CT is superior to chest radiography for evaluating paracardiac lymphadenopathy.
    • Paracardiac adenopathy has diverse causes, including lymphoma, malignancy, and benign conditions.
    • Specific CT features can help distinguish lymphoma from other causes of paracardiac lymphadenopathy.