Superior diaphragmatic lymph nodes: CT assessment.

Area of Science:

• Radiology
• Thoracic Imaging
• Oncology

Background:

• Superior diaphragmatic lymph nodes, also known as cardiophrenic angle or pericardial lymph nodes, are part of the mediastinal lymphatic system.
• Their normal appearance on computed tomography (CT) scans is crucial for differentiating benign findings from pathological conditions.

Purpose of the Study:

• To define the normal CT characteristics of superior diaphragmatic lymph nodes in disease-free adults.
• To establish criteria for identifying lymphadenopathy in this region and its association with malignancy.

Main Methods:

• Retrospective analysis of CT scans from 39 adult patients without diseases affecting lymph nodes.
• Comparison with CT findings in 190 patients with known lymphadenopathy.

Main Results:

• In healthy individuals, 27 ovoid opacities (<5 mm) were identified at known lymph node sites in the anterior diaphragm.
• Enlarged superior diaphragmatic lymph nodes (≥6 mm) were found in 30 of 190 patients with lymphadenopathy.
• Malignant neoplasms, predominantly bronchogenic carcinoma, were pathologically confirmed in all but one of these patients.

Conclusions:

• Normal superior diaphragmatic lymph nodes are small and ovoid on CT.
• Enlargement of these nodes is a significant indicator of malignancy, frequently associated with lung cancer.