Document Detail

Frequency of mediastinal lymphadenopathy in patients with idiopathic pulmonary arterial hypertension.
MedLine Citation:
PMID:  22922444     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: The objective of this study was to assess the frequency of mediastinal lymphadenopathy in patients with idiopathic pulmonary arterial hypertension (IPAH) and describe the correlative clinical features.
METHODS: We conducted a retrospective review of patients with IPAH who underwent right-sided heart catheterization (RHC) and chest CT scan within 3 months of each other. Patients were from a single tertiary institution. CT scans were reviewed for the presence of mediastinal lymphadenopathy (MLAD) with correlating demographic and clinical data, including lymph node size and location, right atrial pressure (RAP), mean pulmonary arterial pressure (mPAP), and the presence of pleural and pericardial effusion.
RESULTS: The study population included 85 patients with a mean age of 48 17.3 years; 70 (82%) were women. Fifteen patients (18%) had MLAD on chest CT scan. The mean short-axis diameter of the largest lymph node in these patients was 13.6 mm (range, 11-20 mm). The enlarged lymph nodes were located predominantly in the lower paratracheal and subcarinal stations. There was no association of MLAD with age, sex, RAP, or mPAP. MLAD was associated with presence of pleural effusion ( P , .02) but not pericardial effusion. Mean left ventricular ejection fraction for those with lymphadenopathy was 63% (range, 45%-76%).
CONCLUSIONS: MLAD without other identifiable causes is seen in approximately one in fi ve patients with IPAH and is associated with pleural effusion but not mPAP, RAP, or left ventricular function.
Teng Moua; David L Levin; Eva M Carmona; Jay H Ryu
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  143     ISSN:  1931-3543     ISO Abbreviation:  Chest     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-03-15     Completed Date:  2013-06-20     Revised Date:  2013-09-16    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  United States    
Other Details:
Languages:  eng     Pagination:  344-48     Citation Subset:  AIM; IM    
Division of Pulmonary and Critical Care, Mayo Clinic Rochester, Rochester, MN 55905, USA.
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MeSH Terms
Hypertension, Pulmonary / complications*,  physiopathology
Lymph Nodes / pathology,  radiography
Lymphatic Diseases / epidemiology*,  etiology*,  radiography
Mediastinal Diseases / epidemiology*,  etiology*,  radiography
Middle Aged
Pleural Effusion / epidemiology
Retrospective Studies
Stroke Volume / physiology
Tomography, X-Ray Computed
Comment In:
Chest. 2013 Jul;144(1):361-2   [PMID:  23880694 ]
Chest. 2013 Jul;144(1):362   [PMID:  23880695 ]

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