Chest CT Findings in EBUS-TBNA-Proven Anthracosis in Enlarged Mediastinal Lymph Nodes

Abstract

Purpose: We demonstrate the multislice computed tomography (MSCT) findings of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA)-proven hilar and mediastinal lymph node enlargement with signs of anthracosis.

Materials and Methods: 53 enlarged lymph nodes in 39 patients (28 male, 11 female) with EBUS-TBNA-confirmed anthracosis were analyzed retrospectively.

Results: The mean short axis diameter of the enlarged lymph nodes with signs of anthracosis was 13.7 mm. Lymph nodes most often showed an oval shape (84 %) and were well defined in 66 % of cases. Lymph node confluence was observed in 32 % of cases. Calcifications were documented in 24.5 % of cases. Contrast enhancement and fatty involution were seen seldom (3.8 %). Lymph node necrosis was not seen.

Conclusion: Lymph node anthracosis may be found most often in enlarged, well defined lymph nodes with an oval shape, frequently associated with confluence and calcifications.

Citation Format:

• Kirchner J, Mueller P, Broll M et al. Chest CT Findings in EBUS-TBNA-Proven Anthracosis in Enlarged Mediastinal Lymph Nodes. Fortschr Röntgenstr 2014; 186: 1122 – 1126

Zusammenfassung

Ziel: Darstellung computertomografischer Befunde von mittels endobronchialer ultraschall-gesteuerter Nadelbiopsie (EBUS-TBNA) gesicherten Fällen vergrößerter hilärer und mediastinaler Lymphknoten mit Zeichen der Anthrakose.

Material und Methoden: Es erfolgte eine retrospektive Auswertung der MSCT von 39 Patienten (28 männlich, 11 weiblich) mit EBUS-TBNA gesicherter Diagnose von 53 vergrößerten anthrakotischen Lymphknoten.

Ergebnisse: Die durchschnittliche Länge der Kurzachse der erfassten Lymphknoten betrug 13,7 mm. Die anthrakotischen Lymphknoten wiesen am häufigsten eine ovale Form (84 %) auf und waren meistens scharf begrenzt (66 %). 32 % der anthrakotischen Lymphknoten waren allerdings mit umliegenden Lymphknoten verbacken. Anthrakotische Lymphknoten zeigen relativ häufig Verkalkungen (24,5 %). Kontrastmittelanreicherungen (3,8 %) oder zentrale Hypodensitäten als Zeichen der fettigen Degenerierung (3,8 %) wurden nur in einzelnen Lymphknoten nachgewiesen. Lymphknoteneinschmelzungen wurden nicht beobachtet.

Schlußfolgerung: Die Lymphknotenanthrakose findet sich am häufigsten in scharf begrenzten ovalären mediastinalen Lymphknoten, kann jedoch relativ häufig auch in konfluierenden und Verkalkungen aufweisenden, vergrößerten mediastinalen Lymphknoten gefunden werden.

Key words

EBUS-TBNA - computed tomography - mediastinum - lymph node - anthracosis - sarcoidosis - lymphadenopathy - occupational/environmental hazards

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