IJCRR - 6(6), March, 2014
Pages: 14-19
ISOLATED MEDIASTINAL LYMPHADENOPATHY - ETIOLOGICAL ANALYSIS
Author: Mandal A., Pan K., Maity P. K., Panchadhyayee S., Sarkar G., Chakraborty S., Choudhury R., Chakrabarti S.
Category: Healthcare
[Download PDF]
Abstract:
Background: The etiology of isolated mediastinal lymphadenopathy (without lung involvement or peripheral lymph node enlargement) is difficult to approach. Though various methods are available for histopathological confirmation, few literatures are there regarding the etiological diagnosis of isolated mediastinal lymphadenopathy. Aims and objective: This study was taken up with the aim to investigate the pattern of involvement of isolated mediastinal lymphadenopathy and to analyze the etiology among the adult patients presenting to a tertiary care institution in Eastern India. Materials and methods: A total of 50 patients were subjected to our study. Non-invasive investigation such as x-ray, CT scan, mantoux test etc. were done and these investigations established only a indirect evidence of etiological diagnosis. For definitive diagnosis, fine needle aspiration biopsy cytology ( FNABC) or biopsy from peripheral lymph node( if any) or various invasive investigations such as CT guided biopsy from mediastinal lymph node, bronchoscopy with transbronchial biopsy, mediastinoscopy or endobronchial ultrasound-guided transbronchial needle aspiration were done wherever feasible. Results: Overall tubercular lymphadenopathy was the most common (45 among 50 patients; 90%) followed by sarcoidosis (3 among 50 patients; 6%), lymphoma (1 among 50 patients; 2%) and carcinoma of lung ( 1 among 50 patients; 2%). Conclusion: So tuberculosis is the leading cause of isolated mediastinal lymphadenopathy.
Keywords: Mediastinal lymphadenopathy.
Citation:
Mandal A., Pan K., Maity P. K., Panchadhyayee S., Sarkar G., Chakraborty S., Choudhury R., Chakrabarti S.. ISOLATED MEDIASTINAL LYMPHADENOPATHY - ETIOLOGICAL ANALYSIS International Journal of Current Research and Review. 6(6), March, 14-19
References:
REFERENCES
1. Lyons HA, Calvy GL, Sammons BP. The diagnosis and classification of mediastinal mass. A study of 782 cases. Ann Intern Med 1959;51: 897-932.
2. Crofton J, Douglas A. Respiratory disease. The incidence of scrofula (tubercular lymphadenitis) in mediaeval Europe. Second edition. Oxford. Blackwell Scientific Publications,1975;chapter 11.
3. Lamont AC, Cremina BJ, Pelteret RM: Radiological patterns of pulmonary tuberculosis in pediatric age group. Pediatr radiol 1986;16:2-7.
4. Leung AN, Muller NL, Pindia PR, Fitz Gerald JM. Primary tuberculosis in childhood: Radiographic manifestation. Radiology 1992;182:87-91.
5. Amorosa JK, Smith PR, Cohen JR, Ramsy C, Leons HA. Tuberculous mediastinal lymphadenitis in adults. Radiology 1978;126:365-368.
6. Miller WT, MacGregor RR. Tuberculosis: frequency of unusual radiographic findings. AJR 1978; 130:867-875.
7. Stead WW,Kerby GR, Schlueter DP, Jodahl CW. The clinical spectrum of primary tuberculosis in adults. Confusion with reinfection in the pathogenesis of chronic tuberculosis. Ann Intern Med 1968;68:731-45.
8. Muller NL. Pulmonary tuberculosis. In : Sperber M, (ed): Radiographic diagnosis of chest disease. Springer- verlag, New York 1990;188-199.
9. Krysl J, Korzeniewska-Kosela M, Muller NL, Fitz Gerald JM. Radiologic feature of pulmonary tuberculosis: an assessment of 188 cases. Can Assoc Radiol J. 1994;45:101-108.
10. Moon WK, Im J, Yeon KM, Han ML. Mediastinal tuberculous lymphadenitis: CT finding of active and inactive disease. AJR 1998, 170:715-718.
11. Gupta SK. Pande JN. Sarcoidosis. In : Pande JN.(ed).Respiratory Medicine In The Tropics. Oxford University Press :1998, p.366.
12. Jindal. S.k. Pulmonary neoplasm. In: Pande JN. (ed). Respiratory Medicine In The Tropics. Oxford University Press: 1998, p.443.
13. Longo .DL. Malignancies of lymphoid cells. In : Longo, Fauci, Kapser, Hauser, Jameson,Loscalzo (eds): Harrisons Principles Of Internal Medicine: 18th ed. Mc Graw Hill Medical.2012. p.934.
14. Pombo F, Rodriguez E,Mato J, Perez-Fontan J, Rivera E, Valuena L. Patterns of contrast enhancement of tuberculous lymph nodes demonstrated by computed tomography. Clin Radiol 1992;46:13-17.
15. Im JG, Song KS, Kang HS, Park JH, Yeon KM, Han ML. Mediastinal tubercular lymphadenitis: CT manifestation. Radiology 1987;164: 115-119.
16. Gulati M, Suri S, Kaur G, Jindal SK, Behera D. CT manifestations of tuberculous madiastinal lymphadenopathy. Indian J Chest Dis Allied Sci. 1994jan-mar;36(1) : 3-7
17. Graham R Cherryman, Bruno Morgan. The lymphatic system. In :Sutton D.(ed). Textbook of Radiology And Imaging. Elsevier Churchill livingstone.2012, p.527.
18. Tiwari M, Aryal G, Shrestha R, Rauniyar SK, Shrestha HG. Histopathologic diagnosis of lymph node biopsies. Nepal Med Coll J. 2007 Dec;9(4): 259-61.
19. Nalladaru ZM, Wessels A. The role of mediastinoscopy for diagnosis of isolated mediastinal lymphadenopathy. Indian J Surg. 2011 Aug; 73(4): 284-6.
20. Straddling P (ed). In : diagnostic bronchoscopy a teaching manual. Churchill Linvinstone 6 th edition,1991,p.72.
21. Trisolini R, Anevalvis S, Tinelli C, Orlandi P, Patelli M. CT pattern of lymphadenopathy in unteated patients undergoing bronchoscopy for suspected sarcoidosis. Respire Med. 2013 jun; 107(6):897-903.
22. Navani N, Lawrence DR, Kolveker S, Hayward M, McAsey D, Kocjan G, Falzon M, Capitanio A,Shaw P, Morris S, Omar RZ, Janes SM; REMEDY Trial Investigators. Endobronchial ultrasound- guided transbronchial needle aspiration prevents mediastinoscopies in the diagnosis of isolated mediastinal lymphadenopathy : a prospective trial. Am J Respir Crit Care Med. 2012 Aug 1; 186(3): 255-60.
|