Thoracic lymphadenopathy in benign diseases: A state of the art review

Respir Med. 2016 Mar:112:10-7. doi: 10.1016/j.rmed.2016.01.021. Epub 2016 Feb 1.

Abstract

Lymphadenopathy is a common radiological finding in many thoracic diseases and may be caused by a variety of infectious, inflammatory, and neoplastic conditions. This review aims to describe the patterns of mediastinal and hilar lymphadenopathy found in benign diseases in immunocompetent patients. Computed tomography is the method of choice for the evaluation of lymphadenopathy, as it is able to demonstrate increased size of individual nodes, abnormalities of the interface between the mediastinum and lung, invasion of surrounding fat, coalescence of adjacent nodes, obliteration of the mediastinal fat, and hypo- and hyperdensity in lymph nodes. Intravenous contrast enhancement may be needed to help distinguish nodes from vessels. The most frequent infections resulting in this finding are tuberculosis and fungal disease (particularly histoplasmosis and coccidioidomycosis). Sarcoidosis is a relatively frequent cause of lymphadenopathy in young adults, and can be distinguished from other diseases - especially when enlarged lymph nodes are found to be multiple and symmetrical. Other conditions discussed in this review are silicosis, drug reactions, amyloidosis, heart failure, Castleman's disease, viral infections, and chronic obstructive pulmonary disease.

Keywords: Benign disease; Computed tomography; Lymphadenopathy; Thoracic disease.

Publication types

  • Review

MeSH terms

  • Amyloidosis / complications
  • Amyloidosis / diagnosis
  • Amyloidosis / diagnostic imaging
  • Berylliosis / complications
  • Berylliosis / diagnosis
  • Berylliosis / diagnostic imaging
  • Castleman Disease / complications
  • Castleman Disease / diagnosis
  • Castleman Disease / diagnostic imaging
  • Coccidioidomycosis / complications
  • Coccidioidomycosis / diagnosis
  • Coccidioidomycosis / diagnostic imaging
  • Diagnosis, Differential
  • Drug Hypersensitivity / complications
  • Drug Hypersensitivity / diagnosis
  • Drug Hypersensitivity / diagnostic imaging
  • Heart Failure / complications
  • Heart Failure / diagnosis
  • Heart Failure / diagnostic imaging
  • Histoplasmosis / complications
  • Histoplasmosis / diagnosis
  • Histoplasmosis / diagnostic imaging
  • Humans
  • Idiopathic Pulmonary Fibrosis / complications
  • Idiopathic Pulmonary Fibrosis / diagnosis
  • Idiopathic Pulmonary Fibrosis / diagnostic imaging
  • Lung Diseases, Fungal / complications
  • Lung Diseases, Fungal / diagnosis
  • Lung Diseases, Fungal / diagnostic imaging
  • Lymph Nodes / diagnostic imaging*
  • Lymphadenitis / diagnosis
  • Lymphadenitis / diagnostic imaging
  • Lymphatic Diseases / diagnosis
  • Lymphatic Diseases / diagnostic imaging*
  • Lymphatic Diseases / etiology
  • Mediastinum
  • Pulmonary Disease, Chronic Obstructive / complications
  • Pulmonary Disease, Chronic Obstructive / diagnosis
  • Pulmonary Disease, Chronic Obstructive / diagnostic imaging
  • Pulmonary Embolism / complications
  • Pulmonary Embolism / diagnosis
  • Pulmonary Embolism / diagnostic imaging
  • Sarcoidosis / complications
  • Sarcoidosis / diagnosis
  • Sarcoidosis / diagnostic imaging
  • Silicosis / complications
  • Silicosis / diagnosis
  • Silicosis / diagnostic imaging
  • Thorax
  • Tomography, X-Ray Computed
  • Tuberculosis, Lymph Node / complications
  • Tuberculosis, Lymph Node / diagnosis
  • Tuberculosis, Lymph Node / diagnostic imaging
  • Virus Diseases / complications
  • Virus Diseases / diagnosis
  • Virus Diseases / diagnostic imaging