Highlights
- •Mediastinal and/or axillar lymphadenopathy reflects the RA disease activity.
- •Mediastinal lymphadenopathy seems to be associated with RA-related lung disease.
Abstract
Background
With recent advances of biological disease-modifying antirheumatic drugs, chest CT
has been increasingly performed in rheumatoid arthritis (RA) patients, and mediastinal/axillar
lymphadenopathy is being detected.
Purpose
To determine the prevalence of mediastinal and axillar lymph node enlargements on
chest CT in RA patients at the initial diagnosis, and to assess its clinical significance.
Material and methods
We retrospectively reviewed the medical records and chest CT findings of 78 consecutive
RA patients. The short axis of the most enlarged lymph nodes (SLN) on CT was measured
for the mediastinal and axillar regions separately. The SLN was classified into two
groups: Group 1, 10 mm or less; and Group 2, larger than 10 mm.
Results
Group 2 was observed in 13 of 78 patients (17%) for the mediastinum, and in 29 (37%)
for the axilla; 11 patients (14%) showed Group 2 for both regions. The Group 2 patients
(n = 31), either mediastinum or axilla, showed significantly higher simple disease activity
index (SDAI) (mean, 36.0) than the patients of Group 1 (n = 47; mean SDAI, 23.0) (p < 0.001). For the mediastinal SLN, the RA-related lung disease was more frequently
observed in the Group 2 patients than in the Group 1 (p = 0.036).
Conclusion
The mediastinal and/or axillar lymphadenopathy on chest CT may reflect the activity
of RA. The mediastinal lymphadenopathy also seems to relate to the RA-related lung
disease.
Keywords
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Article info
Publication history
Published online: February 20, 2019
Accepted:
February 19,
2019
Received in revised form:
February 14,
2019
Received:
March 7,
2018
Footnotes
☆There is no actual or potential conflict of interest in relation to this article.
Identification
Copyright
© 2019 Published by Elsevier Inc.
