![]() Ipsilateral hilar lymphadenopathy is the rule.Distribution of lymphadenopathy is typically asymmetric.Intrathoracic calcification without calcifications involving the spleen or liver may favor sarcoidosis, rather than histoplasmosis.Soft calcifications (faint/cloudy, “icing sugar”) is especially classic for sarcoidosis.Calcification may take various forms (e.g., punctate, amorphous, popcorn, or eggshell).Calcification is seen in 3% of patients who are five years post-diagnosis, and 20% of patients who are 10 years post-diagnosis. Calcification implies chronic sarcoidosis.Calcification eventually develops in ~20% of lymph nodes. ![]() However, bronchial compression is possible (especially involving the right middle lobe). Lymph nodes tend to grow around bronchi and vasculature, without causing compression.Lymph nodes may grow very large (“potato nodes”).Anterior/prevascular lymphadenopathy or especially posterior/paravertebral lymphadenopathy is infrequent, so this should call into question the diagnosis of sarcoidosis.This is atypical so it should raise some concern regarding alternative diagnoses (e.g., lymphoma). Asymmetrical hilar lymphadenopathy occurs in ~4% of patients with sarcoidosis.Garland triad or 1-2-3 sign: Combination of bilateral hilar lymphadenopathy plus right paratracheal lymphadenopathy.Bilateral hilar lymph nodes (95% on CT scan).Sites of involvement in descending order:.Heart failure medication related (chronic exposure) Connective tissue-related interstitial lung disease.Mild lymphadenopathy (e.g., 1-1.5 cm) may be seen with various idiopathic interstitial lung diseases, including: ( 16641412).Silicosis, Coal workers pneumoconiosis.Lymphadenopathy is usually more extensive ipsilateral to the breast cancer.Autopsy studies suggest that intrathoracic lymph nodes may be involved in most patients.SCLC (small cell lung cancer) may cause prominent lymphadenopathy.Intrathoracic primary cancer (Hilar and mediastinal lymphadenopathy is usually due to an intrathoracic carcinoma – especially lung or breast cancer).Chronic lymphocytic leukemia (mediastinal > hilar).Bacteria (primarily atypical organisms):.Mild lymphadenopathy involving only one or two nodal stations is nonspecific, potentially occurring in a wide range of chronic infectious or inflammatory conditions. (Courtesy of David Little, Radiopaedia)Ĭauses of mediastinal and/or hilar lymphadenopathy Widening of the paratracheal stripe with subtle right hilar lymphadenopathy due to lymphoma. Status post esophagectomy with gastric pull through or colonic interposition.Lipoma, thyroid malignancy, parathyroid malignancy.Differential diagnosis of a thickened paratracheal stripe includes: □.Normally, the right paratracheal stripe is The cardiac silhouette here demonstrates a large left central pulmonary artery that obliterates the aortopulmonary window (white arrow). The right descending artery (black arrow) looks a bit like prominent lymph nodes. ( 12608453) For contrast, this is pulmonary hypertension (not mediastinal lymphadenopathy). Hilar lymphadenopathy may be a useful clue to the diagnosis of tularemia.
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |