What is the role of imaging studies in the workup of lymphadenitis?

Updated: Feb 12, 2019
  • Author: Elizabeth Partridge, MD, MPH, MS; Chief Editor: Russell W Steele, MD  more...
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Ultrasonography may be useful for verifying lymph node involvement and taking accurate measurements of enlarged nodes. A study by Wang et al indicated that endobronchial ultrasonography can aid in differentiating between nonmalignant intrathoracic lymphadenopathies, including tuberculosis, sarcoidosis, and reactive lymphadenitis. The investigators found that the presence of reactive lymphadenitis is predicted by the existence of central hilar structure and a lack of clustered formation, as well as by vascular pattern (hilar perfusion or avascularity). Best diagnostic accuracies of 77.1%, 89.2%, and 87.1% were found for tuberculous nodes, sarcoid nodes, and reactive lymphadenitis, respectively. [9]

Chest radiography may be helpful in determining pulmonary involvement or spread of lymphadenopathy to the chest.

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