Thoracic lymphadenopathy in benign diseases: A state of the art review

Lymphadenopathy is a common radiological finding in many thoracic diseases and may be caused by a variety of infectious, inflammatory, and neoplastic conditions. This review aims to describe the patterns of mediastinal and hilar lymphadenopathy found in benign diseases in immunocompetent patients. Computed tomography is the method of choice for the evaluation of lymphadenopathy, as it is able to demonstrate increased size of individual nodes, abnormalities of the interface between the mediastinum and lung, invasion of surrounding fat, coalescence of adjacent nodes, obliteration of the mediastinal fat, and hypo- and hyperdensity in lymph nodes. Intravenous contrast enhancement may be needed to help distinguish nodes from vessels. The most frequent infections resulting in this finding are tuberculosis and fungal disease (particularly histoplasmosis and coccidioidomycosis). Sarcoidosis is a relatively frequent cause of lymphadenopathy in young adults, and can be distinguished from other diseases - especially when enlarged lymph nodes are found to be multiple and symmetrical. Other conditions discussed in this review are silicosis, drug reactions, amyloidosis, heart failure, Castleman's disease, viral infections, and chronic obstructive pulmonary disease. (C) 2016 Elsevier Ltd. All rights reserved.Fed Univ Hlth Sci Porto Alegre, Porto Alegre, RS, BrazilUniv Fed Rio de Janeiro, Rio De Janeiro, BrazilLiverpool Heart & Chest Hosp, Liverpool, Merseyside, EnglandFleury Med Diagnost, Sao Paulo, SP, BrazilHosp Sao Joaquim Beneficencia Portuguesa, Sao Paulo, SP, BrazilLABIMED, Lab Pesquisas Imagens Med, Irmandade Santa Casa Misercordia Porto Alegre, Rua Prof Annes Dias,28 Ctr, BR-9002009 Porto Alegre, RS, BrazilUniv Fed Rio de Janeiro, Rua Thomaz Cameron 43, BR-25685120 Rio De Janeiro, BrazilNHS Fdn Trust, Dept Radiol, Liverpool Heart & Chest Hosp, Thomas Dr Broadgreen, Liverpool L14 3PE, Merseyside, EnglandUniv Fed Sao Paulo, Dept Diagnost Imagem, Rua Napoleao Barros 800, BR-04024002 Sao Paulo, SP, BrazilHop Sao Joaquim Beneficencia Portugues, Dept Radiol & Diagnost Imagem, Rua Maestro Cardim 769, BR-01323001 Sao Paulo, SP, BrazilUniv Fed Sao Paulo, Dept Diagnost Imagem, Rua Napoleao Barros 800, BR-04024002 Sao Paulo, SP, BrazilWeb of Scienc