Haramati L B, Alterman D D, White C S, Kerr A S
Department of Radiology, Albert Einstein College of Medicine, Jacobi Medical Center, Bronx, NY 10461, USA.
J Comput Assist Tomogr. 1997 Jul-Aug;21(4):608-11. doi: 10.1097/00004728-199707000-00015.
Our goal was to determine the prevalence of intrathoracic lymphadenopathy on chest CT in patients with empyema.
We retrospectively identified 27 patients (14 men, 13 women, mean age 43 years) with nontuberculous empyema examined with chest CT. All scans were reviewed by two of three board-certified radiologists for the presence of intrathoracic lymphadenopathy (> or = 1 cm, short axis) in an American Thoracic Society (ATS) nodal station or the internal mammary region. Differences were resolved by consensus.
Thirteen (48%) patients with empyema had lymphadenopathy on chest CT. The mean number of enlarged lymph nodes for the patients with lymphadenopathy was 3.2 (SD +/-2.3, range 1-8). The mean size of the largest lymph node was 1.4 cm (range 1.0-2.5 cm). The lymphadenopathy was unilateral and ipsilateral to the empyema in seven (54%), bilateral in five (38%), and unilateral contralateral to the empyema in one. The distribution of lymphadenopathy according to ATS nodal stations was 4R (n = 8), 7 (n = 6), 10R (n = 5); n = 2 each 2R, 10L, 11L; and n = 1 each 11R, 2L, 4L, and 6. Four patients had internal mammary lymphadenopathy. Pleural fluid and smooth pleural thickening were present in each case. Four patients had follow-up CT after treatment. There was a decrease or resolution of the lymphadenopathy in each case.
Intrathoracic lymphadenopathy is a common CT finding in patients with empyema and occurred in 48% of this series. In patients with smooth pleural thickening and pleural effusion, intrathoracic lymphadenopathy should not be used as a criterion to differentiate empyema from malignant or tuberculous pleural effusion.
我们的目标是确定脓胸患者胸部CT上胸内淋巴结肿大的发生率。
我们回顾性地纳入了27例（14例男性，13例女性，平均年龄43岁）接受胸部CT检查的非结核性脓胸患者。由三位获得委员会认证的放射科医生中的两位对所有扫描结果进行评估，以确定美国胸科学会（ATS）淋巴结区域或乳腺内区域是否存在胸内淋巴结肿大（短轴≥1 cm）。差异通过协商解决。
13例（48%）脓胸患者胸部CT显示有淋巴结肿大。有淋巴结肿大的患者肿大淋巴结的平均数量为3.2个（标准差±2.3，范围1 - 8个）。最大淋巴结的平均大小为1.4 cm（范围1.0 - 2.5 cm）。淋巴结肿大单侧且与脓胸同侧的有7例（54%），双侧的有5例（38%），单侧且与脓胸对侧的有1例。根据ATS淋巴结区域，淋巴结肿大的分布为4R（n = 8）、7（n = 6）、10R（n = 5）；2R、10L、11L各有2例；11R、2L、4L和6各有1例。4例患者有乳腺内淋巴结肿大。每例均有胸腔积液和平滑的胸膜增厚。4例患者治疗后进行了随访CT检查。每例患者的淋巴结肿大均有减轻或消退。
胸内淋巴结肿大是脓胸患者常见的CT表现，本系列中发生率为48%。对于有平滑胸膜增厚和胸腔积液的患者，胸内淋巴结肿大不应作为鉴别脓胸与恶性或结核性胸腔积液的标准。
