Cardiophrenic angle adenopathy: update of causes and significance.

Of 21 cases of cardiophrenic angle adenopathy (CAA) detected on computed tomography (CT) examination, 12 were due to malignant lymphomas, seven to carcinomas, and two to mesotheliomas. Of the nine lesions that were not malignant lymphomas, four were of supradiaphragmatic and five of infradiaphragmatic origin. On average, CAA was detected 4.6 years after the primary neoplasm was diagnosed. Only 29% of the patients were alive 14 months after CAA was detected on CT scans. Radiography was inferior to CT in the detection of CAA, with only 35% of radiography results clearly positive. Malignant lymphoma is a major but not exclusive cause of CAA, and it must be differentiated from lymphatic seeding of supradiaphragmatic and infradiaphragmatic malignancies. Unilateral CAA may point to supradiaphragmatic neoplasms or, if right-sided, to ovarian carcinoma, and bilateral CAA may indicate another neoplasm of infradiaphragmatic origin.