Paratracheal lymphadenopathy: radiographic findings and correlation with CT

Possible signs of paratracheal lymphadenopathy on the posteroanterior (PA) chest radiograph were assessed in 98 patients and correlated with computed tomography (CT). The nodes were normal in size in 62 patients and enlarged (greater than 15 mm) in 36. Among the latter group, widening of the right paratracheal stripe was seen in 11 (31%) and enlargement of the azygos node in 15 (42%). While the lateral contour of the superior vena cava (SVC) was convex in 46 patients (47%), 81 (83%) had an increased density in the region of the SVC. When all four parameters were combined, lymphadenopathy could be detected on the PA view in 87 patients (89%). CT demonstrated that the enlarged nodes were anterolateral rather than directly lateral to the trachea and also immediately posterior to the SVC, explaining the findings on the PA radiograph.