Gawne-Cain M L, Hansell D M
Department of Radiology, Royal Brompton Hospital, London, UK.
Clin Radiol. 1996 Apr;51(4):263-7. doi: 10.1016/s0009-9260(96)80343-6.
Following granulomatous involvement, calcification of hilar and mediastinal lymph nodes is common and calcified nodes are frequently identified on computed tomography (CT). The aim of this study was to establish whether there is any difference in the pattern and distribution of such calcifications in tuberculosis (TB) and sarcoidosis.
The thoracic CT scans of 77 patients with proven TB (n=28) or sarcoidosis (n=49) were studied retrospectively. Lymph nodes were categorized by size and pattern of calcification: diffuse/homogeneous, focal deposits, eggshell, and complete nodal replacement by calcification. The position of hilar or mediastinal calcified nodes was recorded.
Nodal calcification was present in 26 fo 49 (53%) sarcoidosis patients and 13 of 28 (46%) TB patients. The mean short axis diameter of calcified nodes was significantly larger in sarcoidosis patients (sarcoidosis 12 mm, TB 7 mm, P < 0.003). A focal pattern of calcification was commoner in sarcoidosis (58% sarcoidosis nodes, 23% TB nodes) and complete calcification in TB (62% TB nodes, 27% sarcoidosis nodes). When hilar node calcification was present it was more likely to be bilateral in sarcoidosis than in TB (65% and 8%, respectively, P < 0.001).
CT of the mediastinum shows significant differences in distribution and pattern of calcification in lymph nodes in TB and sarcoidosis. Possible explanations for these differences include the route of lymphatic drainage of pulmonary TB and the caseating nature of tuberculous granulomas.
在肉芽肿累及后，肺门和纵隔淋巴结钙化很常见，并且在计算机断层扫描（CT）上经常能发现钙化的淋巴结。本研究的目的是确定在结核病（TB）和结节病中，这种钙化的形态和分布是否存在差异。
回顾性研究了77例经证实患有TB（n = 28）或结节病（n = 49）患者的胸部CT扫描结果。根据淋巴结钙化的大小和形态进行分类：弥漫性/均匀性、局灶性沉积、蛋壳样以及钙化完全替代淋巴结。记录肺门或纵隔钙化淋巴结的位置。
49例结节病患者中有26例（53%）出现淋巴结钙化，28例TB患者中有13例（46%）出现淋巴结钙化。结节病患者钙化淋巴结的平均短轴直径明显更大（结节病为12mm，TB为7mm，P < 0.003）。局灶性钙化形态在结节病中更常见（结节病淋巴结为58%，TB淋巴结为23%），而TB中完全钙化更常见（TB淋巴结为62%，结节病淋巴结为27%）。当存在肺门淋巴结钙化时，结节病中双侧出现的可能性比TB更大（分别为65%和8%，P < 0.001）。
纵隔CT显示TB和结节病中淋巴结钙化的分布和形态存在显著差异。这些差异的可能解释包括肺结核的淋巴引流途径以及结核性肉芽肿的干酪样性质。
