CT assessment of axillary lymphadenopathy in patients with rheumatoid arthritis: association with disease activity and severity
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Axillary lymph nodes (ALNs) are often seen on chest computed tomography (CT) in rheumatoid arthritis (RA) patients. Early reports described lymphadenopathy as one of the systemic manifestations rather than regional lymphadenopathy secondary to drainage from the affected joints. Subsequently, the importance of the immunological events occurring in draining lymph nodes in the development of arthritis was documented.
To identify the relationships of local disease activity and background characteristics, including systemic disease activity, systemic disease activity, with axillary lymphadenopathy (AL) in RA using CT.
RA patients who had undergone chest CT were retrospectively analyzed. The maximum short axis of the ALNs was measured, and the number of positive ALNs ≥ 5 mm was counted. Tender and swollen joints in the upper limbs were counted as indicators of local disease activity. Background characteristics and systemic disease activity were assessed based on the selected RA indicators. Correlations between AL and both local disease activity and background characteristics including systemic disease activity were analyzed.
Of 135 patients, 58 had positive ALNs (average size 7.97 mm, range up to 15 mm). The presence of positive unilateral ALNs was correlated with the severity of ipsilateral upper limb arthritis. Multivariate analysis showed correlations between AL and both local disease activity and serological findings such as serum C-reactive protein (CRP) and immunoglobulin (Ig) G.
AL in patients with RA was correlated with local arthritis activity, as well as background characteristics and systemic disease activity.
KeywordsArthritis Axillary lymphadenopathy Lymph node Lymphadenopathy Rheumatoid arthritis
The authors would like to thank Dr. Tomoyuki Akita for his valuable advice and assistance with the statistical analysis of this study.
MH: conception and design of the study, analysis and interpretation of the data, collection and assembly of data, drafting of the article, and critical revision of the article for important intellectual content. FS: conception and design of the study, analysis and interpretation of the data, drafting of the article, and critical revision of the article for important intellectual content. NK: collection and assembly of data. AO: collection and assembly of data. HK: collection and assembly of data. YS: conception and design of the study, analysis and interpretation of the data collection and assembly of data, drafting of the article, and critical revision of the article for important intellectual content.
Compliance with ethical standards
Conflict of interest
Mizue Hasegawa, Fumikazu Sakai, Naoko Konda, Asako Okabayashi, Hideki Katsura, and Yohei Seto declare that they have no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Protocol number: 3903. Date of approval: 25 Apr 2016. Approving institution: Tokyo Women’s Medical University, Tokyo, Japan.
For this type of study formal consent is not required.
External editing support
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