Thoracic lymphadenopathies in diffuse systemic sclerosis: an observational study on 48 patients using computed...

Area of Science:

• Radiology
• Pulmonology
• Rheumatology

Background:

• Systemic sclerosis (SSc) patients often develop interstitial lung disease (ILD), detectable via thoracic multidetector computed tomography (MDCT).
• Thoracic MDCT may reveal thoracic lymphadenopathies (LAP) of uncertain significance in SSc patients.

Purpose of the Study:

• To characterize thoracic lymphadenopathies (LAP) in diffuse systemic sclerosis (SSc).
• To assess the clinical significance of thoracic LAP in diffuse SSc patients.

Main Methods:

• A monocentric observational study included adult patients with diffuse SSc.
• Data collected included patient demographics, first thoracic MDCT findings, PET-CT results, and outcomes.
• Comparisons were made between patients with and without thoracic LAP.

Main Results:

• 30 out of 48 (62.5%) SSc patients had ILD, and 23 (48%) had thoracic LAP on initial MDCT.
• Thoracic LAP were typically multiple, small, and located in mediastinal chains, with hypermetabolism noted on PET-CT in 73.3%.
• LAP presence correlated with male sex, silica exposure, and increased ILD extent (Goh score, semi-quantitative scores).

Conclusions:

• Thoracic LAP are frequent in diffuse SSc, often multiple and moderately hypermetabolic, correlating with ILD extent.
• Silica exposure may explain thoracic LAP in SSc patients without ILD.
• Thoracic LAP did not significantly affect mortality or immunosuppressive treatment initiation in this cohort.