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Intrathoracic lymphadenopathy in patients with empyema
L B Haramati1, D D Alterman, C S White
1Department of Radiology, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, NY 10461, USA.
Journal of Computer Assisted Tomography
|July 1, 1997
Summary
Intrathoracic lymphadenopathy is a common finding in chest CT scans of patients with empyema, present in 48% of cases. This finding should not be used to distinguish empyema from other pleural effusions.
Area of Science:
- Thoracic imaging
- Pulmonology
- Radiology
Background:
- Empyema is a serious pleural infection.
- Chest CT is a key diagnostic tool for pleural diseases.
Purpose of the Study:
- To determine the prevalence of intrathoracic lymphadenopathy in patients diagnosed with empyema using chest CT.
- To assess the characteristics and distribution of lymphadenopathy in empyema.
Main Methods:
- Retrospective analysis of chest CT scans from 27 patients with nontuberculous empyema.
- Review of scans by board-certified radiologists for intrathoracic lymphadenopathy (≥1 cm short axis) in specified nodal stations and internal mammary regions.
- Consensus resolution for discrepancies.
Main Results:
- Intrathoracic lymphadenopathy was identified in 48% (13/27) of patients with empyema.
- Enlarged lymph nodes averaged 3.2 in number and 1.4 cm in largest size.
- Lymphadenopathy was often unilateral and ipsilateral to the empyema, with common involvement of ATS stations 4R and 7.
Conclusions:
- Intrathoracic lymphadenopathy is a frequent CT finding in empyema.
- The presence of lymphadenopathy in conjunction with pleural effusion and thickening does not reliably differentiate empyema from malignant or tuberculous pleural effusions.