Prevalence of enlarged mediastinal lymph nodes in heavy smokers—a comparative study
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To evaluate the frequency of enlarged hilar or mediastinal lymph nodes in heavy smokers (more than 10 pack years) compared with non- smokers.
Material and methods
In a prospective study the CT findings of 88 consecutive patients (44 heavy smokers, 44 non- smokers) were analysed. Exclusion criteria were history of thoracic malignancy, sarcoidosis, occupational dust exposure or clinical evidence of pneumonia. Prevalence, size and site of enlarged lymph nodes were assessed by multidetector computed tomography (MDCT) and correlated with the cigarette consumption and the CT- findings of bronchitis and emphysema.
Twenty-three of the 44 heavy smokers (52%) showed enlarged mediastinal lymph nodes. Non- smokers showed enlarged lymph nodes in 9% (4/44). The most common site of enlarged lymph nodes was the regional station 7 according to the ATS mapping (subcarinal). The difference between the frequency of enlarged lymph nodes in heavy smokers and non- smokers was significant (chi- square 19.3, p < 0.0001). Airway wall thickening and emphysema were often associated with an increased number of enlarged nodes.
The present study demonstrates that enlarged mediastinal lymph nodes may occur in a rather high percentage of heavy smokers, especially in those with a MDCT finding of severe bronchitis.
KeywordsTobacco MDCT Lymph node enlargement Comparative study
- 2.Heyneman LE, Ward S, Lynch DA, Remy-Jardin M, Johkoh T, Müller NL (1999) Respiratory bronchiolitis, respiratory bronchiolitis-associated interstitial lung disease, and desquamative interstitial pneumonia: different entities or part of the spectrum of the same disease process? AJR Am J Roentgenol 173:1617–22PubMedGoogle Scholar
- 12.American Thoracic Society. Medical section of the American Lung Association (1983) Clinical staging of primary lung cancer. Am Rev Respir Dis 127:659–64Google Scholar
- 26.Libshitz HI, McKenna RJ (1984) Mediastinal lymph node size in lung cancer. Am J Roentgenol 143:715–8Google Scholar
- 28.Billé A, Pelosi E, Skanjeti A, Arena V, Errico L, Borasio P, Mancini M, Ardissone F (2009) Preoperative intrathoracic lymph node staging in patients with non-small-cell lung cancer: accuracy of integrated positron emission tomography and computed tomography. Eur J Cardiothorac Surg 36:440–5PubMedCrossRefGoogle Scholar