Differential diagnosis of intrathoracic lymph node lesions in lymphomas
Stashuk, G.A.; Dubrova, S.E.; Adel Salem Ali Numan
Vestnik Rentgenologii i Radiologii 2008(4-6): 16-24
2008
ISSN/ISBN: 0042-4676 PMID: 21337746 Document Number: 615886
Thoracic lymphomas most commonly afflict the lymph nodes of the mediastinum and lung roots. A diagnostic difficulty is due to selectivity of the lesion in different groups of lymph nodes, which may be accompanied by no x-ray changes in the early stages of the process and by a disseminated lesion and polymorphism of its manifestations in the extensive stages of the disease. Two hundred and thirty-three patients with intrathoracic lymph node lesion were examined in 2003 to 2008. Conventional x-ray was a primary study. Later on multispiral computed tomography (MSCT) was performed, which was, if needed, supplemented by bolus contrast media injection and, in some cases, by magnetic resonance imaging. Lymph nodes were involved by lymphoma in 154 patients, among which lymphogranulomatosis was in 74 cases, malignant non-Hodgkin's lymphoma in 59, and chronic lympholeukemia in 21. Seventy-nine patients had a similar x-ray pattern that required a differential diagnosis with lymphomas (central cancer in 29 cases, sarcoidosis in 16, metastatic lesion in 12, pneumoconiosis in 10, tuberculosis in 7, Castleman's disease in 2, and lymphangioleiomatosis in 1. the application of state-of-the-art radio technologies, primary MSCT, provides the maximal accurate differential diagnosis of intrathoracic lymph node lesion in lymphoma, which is the basis of timely treatment.