Role of multislice computed tomography in evaluation of thoracic lymphadenopathy

Mediastinal masses and lymphadenopathy are often incidentally detected on chest radiograph. Despite diagnostic limitations, the chest radiograph is also important for detecting and localizing mediastinal masses and lymphadenopathy when suspected clinically. Multislice computed tomography (CT) has transformed CT from a transaxial cross-sectional technique to a three-dimensional imaging modality. The aim of this study was to assess the role of multislice CT in evaluation of thoracic lymphadenopathy (lymph node). The present study was conducted on 25 patients with thoracic lymphadenopathy on plain chest radiograph or clinically suspected with unremarkable chest radiograph recruited from the main university hospital of Alexandria. All patients were subjected to detailed history taking, full clinical examination, and conventional radiograph and multidetector CT of the chest with intravenous contrast, using four and six multidetector CT scanners, GE Lightspeed and Simens Emotion 6, respectively. The scan parameters used were 120 kVP and less than 240 mA per slice; tube rotation was 0.75 s and slice thickness was 1.25 mm. Fiberoptic bronchoscopy with transbronchial needle aspiration biopsy was performed according to radiological and bronchoscopic landmarks for cytological examination and histological examination. In this study, metastatic lymphadenopathy was encountered in nine patients, pulmonary tuberculosis in four, lymphoma in eight, and sarcoidosis in four. The diagnosis was confirmed by transbronchial needle aspiration biopsy and percutaneous needle aspiration from the peripheral lymph node. Multislice CT of the chest is considered as a simple, safe, and minimally invasive procedure. Egypt J Broncho 2014 8:17–22