Payam Mehrain1, Amin Momeni Moghaddam2, Elham Tavakol2, Afshin Amini3, Mehrdad Moghimi4, Ali Kabir5, Ali Akbar Velayati6. 1. Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: mehrian11@hotmail.com. 2. Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran. 3. Department of Emergency Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 4. Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 5. Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran. 6. Mycobacteriology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Abstract
BACKGROUND/ OBJECTIVES: Pediatric tuberculosis is usually a primary infection presenting mainly as mediastinal or hilar adenopathy in computed tomography (CT) scan. In this study, we study the distribution and other CT scan characteristics of mediastinal lymphadenopathy in childhood tuberculosis. METHODS: Chest CT scans of 75 cases of pediatric tuberculosis at Masih Daneshvari Hospital in Tehran, Iran, from 2009 to 2013 were studied regarding characteristics of mediastinal lymphadenopathy. RESULTS: Mean±standard deviation age of cases was 11.2±4.6years. Lymphadenopathy (mediastinal/hilar) was detected in 94.7% of cases. Most of the lymphadenopathies were located in the lower paratracheal (81.7%), upper paratracheal (69.1%), hilar (53.5%), and subcarinal (47.9%) stations. Perilymph node fatty stranding, lymphadenopathy conglomeration, bronchial pressure by the lymph nodes, and lymph node calcification were noted in 74.6%, 52.11%, 4.23%, and 5.6% of cases, respectively. Bilateral, right, and left lung parenchymal involvement were reported in 45%, 25%, and 8% of cases, respectively. Lung parenchymal involvement was significantly correlated with lymphadenopathies in subcarinal (p<0.001), hilar (p<0.001), subaortic (p=0.03), lower paratracheal (p=0.037), and axillary (p=0.006) stations. Right- and left-sided pleural effusions were observed in 12.7% and 7% of cases, respectively. CONCLUSION: Attention to distribution and characteristics of mediastinal lymphadenopathy can help differentiate tuberculosis from other causes of pediatric mediastinal lymphadenopathy.
BACKGROUND/ OBJECTIVES:Pediatric tuberculosis is usually a primary infection presenting mainly as mediastinal or hilar adenopathy in computed tomography (CT) scan. In this study, we study the distribution and other CT scan characteristics of mediastinal lymphadenopathy in childhood tuberculosis. METHODS: Chest CT scans of 75 cases of pediatric tuberculosis at Masih Daneshvari Hospital in Tehran, Iran, from 2009 to 2013 were studied regarding characteristics of mediastinal lymphadenopathy. RESULTS: Mean±standard deviation age of cases was 11.2±4.6years. Lymphadenopathy (mediastinal/hilar) was detected in 94.7% of cases. Most of the lymphadenopathies were located in the lower paratracheal (81.7%), upper paratracheal (69.1%), hilar (53.5%), and subcarinal (47.9%) stations. Perilymph node fatty stranding, lymphadenopathy conglomeration, bronchial pressure by the lymph nodes, and lymph node calcification were noted in 74.6%, 52.11%, 4.23%, and 5.6% of cases, respectively. Bilateral, right, and left lung parenchymal involvement were reported in 45%, 25%, and 8% of cases, respectively. Lung parenchymal involvement was significantly correlated with lymphadenopathies in subcarinal (p<0.001), hilar (p<0.001), subaortic (p=0.03), lower paratracheal (p=0.037), and axillary (p=0.006) stations. Right- and left-sided pleural effusions were observed in 12.7% and 7% of cases, respectively. CONCLUSION: Attention to distribution and characteristics of mediastinal lymphadenopathy can help differentiate tuberculosis from other causes of pediatric mediastinal lymphadenopathy.