Mediastinal and axillar lymphadenopathy in patients with rheumatoid arthritis: prevalence and clinical significance.
CT
Disease activity
Lung disease
Lymphadenopathy
Rheumatoid arthritis
Journal
Clinical imaging
ISSN: 1873-4499
Titre abrégé: Clin Imaging
Pays: United States
ID NLM: 8911831
Informations de publication
Date de publication:
Historique:
received:
07
03
2018
revised:
14
02
2019
accepted:
19
02
2019
pubmed:
1
3
2019
medline:
19
11
2019
entrez:
1
3
2019
Statut:
ppublish
Résumé
With recent advances of biological disease-modifying antirheumatic drugs, chest CT has been increasingly performed in rheumatoid arthritis (RA) patients, and mediastinal/axillar lymphadenopathy is being detected. To determine the prevalence of mediastinal and axillar lymph node enlargements on chest CT in RA patients at the initial diagnosis, and to assess its clinical significance. We retrospectively reviewed the medical records and chest CT findings of 78 consecutive RA patients. The short axis of the most enlarged lymph nodes (SLN) on CT was measured for the mediastinal and axillar regions separately. The SLN was classified into two groups: Group 1, 10 mm or less; and Group 2, larger than 10 mm. Group 2 was observed in 13 of 78 patients (17%) for the mediastinum, and in 29 (37%) for the axilla; 11 patients (14%) showed Group 2 for both regions. The Group 2 patients (n = 31), either mediastinum or axilla, showed significantly higher simple disease activity index (SDAI) (mean, 36.0) than the patients of Group 1 (n = 47; mean SDAI, 23.0) (p < 0.001). For the mediastinal SLN, the RA-related lung disease was more frequently observed in the Group 2 patients than in the Group 1 (p = 0.036). The mediastinal and/or axillar lymphadenopathy on chest CT may reflect the activity of RA. The mediastinal lymphadenopathy also seems to relate to the RA-related lung disease.
Sections du résumé
BACKGROUND
BACKGROUND
With recent advances of biological disease-modifying antirheumatic drugs, chest CT has been increasingly performed in rheumatoid arthritis (RA) patients, and mediastinal/axillar lymphadenopathy is being detected.
PURPOSE
OBJECTIVE
To determine the prevalence of mediastinal and axillar lymph node enlargements on chest CT in RA patients at the initial diagnosis, and to assess its clinical significance.
MATERIAL AND METHODS
METHODS
We retrospectively reviewed the medical records and chest CT findings of 78 consecutive RA patients. The short axis of the most enlarged lymph nodes (SLN) on CT was measured for the mediastinal and axillar regions separately. The SLN was classified into two groups: Group 1, 10 mm or less; and Group 2, larger than 10 mm.
RESULTS
RESULTS
Group 2 was observed in 13 of 78 patients (17%) for the mediastinum, and in 29 (37%) for the axilla; 11 patients (14%) showed Group 2 for both regions. The Group 2 patients (n = 31), either mediastinum or axilla, showed significantly higher simple disease activity index (SDAI) (mean, 36.0) than the patients of Group 1 (n = 47; mean SDAI, 23.0) (p < 0.001). For the mediastinal SLN, the RA-related lung disease was more frequently observed in the Group 2 patients than in the Group 1 (p = 0.036).
CONCLUSION
CONCLUSIONS
The mediastinal and/or axillar lymphadenopathy on chest CT may reflect the activity of RA. The mediastinal lymphadenopathy also seems to relate to the RA-related lung disease.
Identifiants
pubmed: 30818164
pii: S0899-7071(19)30047-6
doi: 10.1016/j.clinimag.2019.02.014
pii:
doi:
Substances chimiques
Antirheumatic Agents
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
140-143Informations de copyright
Copyright © 2019. Published by Elsevier Inc.