Related Experiment Video
Updated: Aug 8, 2026
Imaging Features of Systemic Sclerosis-Associated Interstitial Lung Disease
Published on: June 16, 2020
Prevalence of pathologically proven intrapulmonary lymph nodes and their appearance on CT
M S Bankoff1, N J McEniff, R A Bhadelia
1Department of Radiology, New England Medical Center, Tufts University School of Medicine, Boston, MA 02111, USA.
Insights
Intrapulmonary lymph nodes are often found in patients undergoing surgery for lung nodules. These nodes, though not well-known, should be considered in diagnoses, especially those in lower lung lobes.
Area of Science:
- Radiology
- Pulmonology
- Pathology
Background:
- Intrapulmonary lymph nodes are an uncommon finding.
- Computed tomography (CT) is used to detect peripheral pulmonary abnormalities.
Purpose of the Study:
- To determine the prevalence of intrapulmonary lymph nodes.
- To describe the CT appearance of intrapulmonary lymph nodes.
Main Methods:
- Retrospective review of 184 patients undergoing minithoracotomy for CT-detected pulmonary nodules (1980-1994).
- Analysis of 96 patients with well-circumscribed peripheral pulmonary nodules.
- Radiographic assessment of pathologically proven intrapulmonary lymph nodes by two radiologists.
Main Results:
- Intrapulmonary lymph nodes were pathologically confirmed in 17 (18%) of 96 patients.
- Nodule sizes ranged from 7 to 12 mm in diameter.
- All nodules were located within 20 mm of the visceral pleura, predominantly in lower lobes.
Conclusions:
- Intrapulmonary lymph nodes are found in a significant number of patients evaluated for pulmonary nodules.
- These nodes lack specific CT features but should be included in the differential diagnosis.
- Consider intrapulmonary lymph nodes in cases of single or multiple parenchymal nodules, particularly in lower lobes.
Objective:
The objective of this study was to assess the prevalence of pathologically proven intrapulmonary lymph nodes and to evaluate their appearance on CT.
Materials And Methods:
Over a 15-year period (1980-1994), 184 patients underwent minithoracotomies for evaluation of CT-detected peripheral pulmonary abnormalities. Of these 184 patients, 96 had well-circumscribed peripheral pulmonary nodules. The size, position, and radiographic features of all pathologically proven intrapulmonary lymph nodes were independently assessed by two experienced radiologists.
Results:
The nodules in 17 (18%) of the 96 patients with well-circumscribed peripheral pulmonary nodules were pathologically proven to be intrapulmonary lymph nodes. Two of the 17 patients had two nodules; the remaining patients had solitary nodules. The maximum diameter of the nodules varied from 7 to 12 mm. All the nodes were located within 20 mm of a visceral pleural surface. Twelve of the nodules were located in the lower lobes, and the remaining nodules were located in the right middle lobe.
Conclusion:
Although intrapulmonary lymph nodes are not a well-known entity, our results indicate that they are discovered in a significant number of patients who undergo minithoracotomies for the evaluation of CT-detected pulmonary nodules. Although these lymph nodes do not possess any specific CT appearance, they should be considered in the differential diagnosis of single (or multiple) parenchymal nodules, particularly those found in the lower lobes.
Related Concept Videos
01:31Pulmonary Tuberculosis III
The first classification is based on the development of the disease, and it includes the following categories:
01:26Pulmonary Tuberculosis IV
Several diagnostic approaches are used to detect TB. The conventional method is the Tuberculin Skin Test (TST), also known as the Mantoux test. However, this method has...