Mediastinal lymphadenopathy in pediatric tuberculosis in computed tomography scan

International Journal of Mycobacteriology

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Mediastinal lymphadenopathy in pediatric tuberculosis in computed tomography scan Payam Mehrain a,*, Amin Momeni Moghaddam a, Elham Tavakol a, Afshin Amini b, Mehrdad Moghimi c, Ali Kabir d, Ali Akbar Velayati e a

Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran b Department of Emergency Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran c Department of Surgery, Shahid Beheshti University of Medical Sciences, Tehran, Iran d Minimally Invasive Surgery Research Center, Iran University of Medical Sciences, Tehran, Iran e Mycobacteriology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iran

A R T I C L E I N F O

A B S T R A C T

Article history:

Background/objectives: Pediatric tuberculosis is usually a primary infection presenting

Received 25 September 2016

mainly as mediastinal or hilar adenopathy in computed tomography (CT) scan. In this

Received in revised form

study, we study the distribution and other CT scan characteristics of mediastinal lym-

17 October 2016

phadenopathy in childhood tuberculosis.

Accepted 5 November 2016

Methods: Chest CT scans of 75 cases of pediatric tuberculosis at Masih Daneshvari Hospital

Available online 25 November 2016

in Tehran, Iran, from 2009 to 2013 were studied regarding characteristics of mediastinal lymphadenopathy.

Keywords:

Results: Mean ± standard deviation age of cases was 11.2 ± 4.6 years. Lymphadenopathy

Computed tomography scan

(mediastinal/hilar) was detected in 94.7% of cases. Most of the lymphadenopathies were

Mediastinal lymphadenopathy

located in the lower paratracheal (81.7%), upper paratracheal (69.1%), hilar (53.5%), and sub-

Pediatric tuberculosis

carinal (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.

* Corresponding author at: Telemedicine Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Daar-Abad, Niavaran, Tehran 19569-44413, Iran. Tel.: +98 021 26105358; fax: +98 021 27122025. E-mail address: [email protected] (P. Mehrain). Peer review under responsibility of Asian African Society for Mycobacteriology. http://dx.doi.org/10.1016/j.ijmyco.2016.11.019

International Journal of Mycobacteriology

Conflicts of interest The authors have no conflicts of interest to declare.

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