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Thoracic lymphadenopathies in diffuse systemic sclerosis: an observational study on 48 patients using computed tomography
BACKGROUND: Thoracic multidetector computed tomography (MDCT) is essential for the detection of interstitial lung disease (ILD) in patients with systemic sclerosis (SSc). Thoracic MDCT assessment can reveal the presence of thoracic lymphadenopathies (LAP) whose signification remains uncertain. The p...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8788097/ https://www.ncbi.nlm.nih.gov/pubmed/35078448 http://dx.doi.org/10.1186/s12890-022-01837-y |
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author | Renaud, Arthur Pautre, Raphael Morla, Olivier Achille, Aurélie Durant, Cécile Espitia, Olivier Frampas, Eric Agard, Christian |
author_facet | Renaud, Arthur Pautre, Raphael Morla, Olivier Achille, Aurélie Durant, Cécile Espitia, Olivier Frampas, Eric Agard, Christian |
author_sort | Renaud, Arthur |
collection | PubMed |
description | BACKGROUND: Thoracic multidetector computed tomography (MDCT) is essential for the detection of interstitial lung disease (ILD) in patients with systemic sclerosis (SSc). Thoracic MDCT assessment can reveal the presence of thoracic lymphadenopathies (LAP) whose signification remains uncertain. The purpose of the study was to describe the characteristics and to assess the significance of thoracic LAP in patients with diffuse SSc. METHODS: We conducted a monocentric observational study on adult patients with diffuse SSc, and collected general patient and first thoracic MDCT characteristics, PET-CT and outcome data. Comparisons were made between patients with and without thoracic LAP. RESULTS: Forty-eight patients were included. There were 30 patients (62.5%) with an ILD and 23 (48%) with at least one thoracic LAP on the first MDCT assessment. Median number per patient of thoracic LAP was 3 [1–8], with a mean size of 11.7 ± 1.7 mm, mainly located in right para-tracheal area (22.8% of the total number of LAP), right hilar area (20.3%), left hilar area (6.5%), and sub-carinal area (15.2%). PET-CT showed lymph node hypermetabolism in 11/15 patients (73.3%) with mean SUVmax at 4 ± 1.3. There were significantly more males (p = 0.002) and more patients exposed to silica (p = 0.001) in patients with thoracic LAP. ILD was significantly more extended according to Goh score (p = 0.03), and using semi-quantitative score for mixed ground-glass reticulation (p = 0.01) and global abnormalities (p = 0.03) in patients with thoracic LAP and ILD. Thirteen patients (27.1%) died during follow-up without significant difference according to the presence or not of thoracic LAP (p = 0.15). There was also no significant difference concerning immunosuppressive treatment initiation (p = 0.17). CONCLUSIONS: Thoracic LAP are common in diffuse SSc and are generally multiple, not bulky, moderately hypermetabolic, and located at the base of the mediastinum lymph node chains. Their presence correlates with the extent of ILD. In absence of ILD, thoracic LAP presence seems to be often explained by silica exposure. Trial Registration: NA. |
format | Online Article Text |
id | pubmed-8788097 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-87880972022-02-03 Thoracic lymphadenopathies in diffuse systemic sclerosis: an observational study on 48 patients using computed tomography Renaud, Arthur Pautre, Raphael Morla, Olivier Achille, Aurélie Durant, Cécile Espitia, Olivier Frampas, Eric Agard, Christian BMC Pulm Med Research BACKGROUND: Thoracic multidetector computed tomography (MDCT) is essential for the detection of interstitial lung disease (ILD) in patients with systemic sclerosis (SSc). Thoracic MDCT assessment can reveal the presence of thoracic lymphadenopathies (LAP) whose signification remains uncertain. The purpose of the study was to describe the characteristics and to assess the significance of thoracic LAP in patients with diffuse SSc. METHODS: We conducted a monocentric observational study on adult patients with diffuse SSc, and collected general patient and first thoracic MDCT characteristics, PET-CT and outcome data. Comparisons were made between patients with and without thoracic LAP. RESULTS: Forty-eight patients were included. There were 30 patients (62.5%) with an ILD and 23 (48%) with at least one thoracic LAP on the first MDCT assessment. Median number per patient of thoracic LAP was 3 [1–8], with a mean size of 11.7 ± 1.7 mm, mainly located in right para-tracheal area (22.8% of the total number of LAP), right hilar area (20.3%), left hilar area (6.5%), and sub-carinal area (15.2%). PET-CT showed lymph node hypermetabolism in 11/15 patients (73.3%) with mean SUVmax at 4 ± 1.3. There were significantly more males (p = 0.002) and more patients exposed to silica (p = 0.001) in patients with thoracic LAP. ILD was significantly more extended according to Goh score (p = 0.03), and using semi-quantitative score for mixed ground-glass reticulation (p = 0.01) and global abnormalities (p = 0.03) in patients with thoracic LAP and ILD. Thirteen patients (27.1%) died during follow-up without significant difference according to the presence or not of thoracic LAP (p = 0.15). There was also no significant difference concerning immunosuppressive treatment initiation (p = 0.17). CONCLUSIONS: Thoracic LAP are common in diffuse SSc and are generally multiple, not bulky, moderately hypermetabolic, and located at the base of the mediastinum lymph node chains. Their presence correlates with the extent of ILD. In absence of ILD, thoracic LAP presence seems to be often explained by silica exposure. Trial Registration: NA. BioMed Central 2022-01-25 /pmc/articles/PMC8788097/ /pubmed/35078448 http://dx.doi.org/10.1186/s12890-022-01837-y Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Renaud, Arthur Pautre, Raphael Morla, Olivier Achille, Aurélie Durant, Cécile Espitia, Olivier Frampas, Eric Agard, Christian Thoracic lymphadenopathies in diffuse systemic sclerosis: an observational study on 48 patients using computed tomography |
title | Thoracic lymphadenopathies in diffuse systemic sclerosis: an observational study on 48 patients using computed tomography |
title_full | Thoracic lymphadenopathies in diffuse systemic sclerosis: an observational study on 48 patients using computed tomography |
title_fullStr | Thoracic lymphadenopathies in diffuse systemic sclerosis: an observational study on 48 patients using computed tomography |
title_full_unstemmed | Thoracic lymphadenopathies in diffuse systemic sclerosis: an observational study on 48 patients using computed tomography |
title_short | Thoracic lymphadenopathies in diffuse systemic sclerosis: an observational study on 48 patients using computed tomography |
title_sort | thoracic lymphadenopathies in diffuse systemic sclerosis: an observational study on 48 patients using computed tomography |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8788097/ https://www.ncbi.nlm.nih.gov/pubmed/35078448 http://dx.doi.org/10.1186/s12890-022-01837-y |
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