Impact of Parenchymal Tuberculosis Sequelae on Mediastinal Lymph Node Staging in Patients with Lung Cancer.
10.3346/jkms.2011.26.1.67
- Author:
Seung Heon LEE
1
;
Joo Won MIN
;
Chang Hoon LEE
;
Chang Min PARK
;
Jin Mo GOO
;
Doo Hyun CHUNG
;
Chang Hyun KANG
;
Young Tae KIM
;
Young Whan KIM
;
Sung Koo HAN
;
Young Soo SHIM
;
Jae Joon YIM
Author Information
1. Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine and Lung Institute, Seoul National University College of Medicine, Seoul, Korea. yimjj@snu.ac.kr
- Publication Type:Original Article
- Keywords:
Latent Tuberculosis;
Lung Neoplasms;
Mediastinum;
Tuberculosis;
Lymph Node
- MeSH:
Aged;
Aged, 80 and over;
Female;
Fluorodeoxyglucose F18/diagnostic use;
Humans;
Latent Tuberculosis/*complications/pathology;
Lung Neoplasms/complications/*diagnosis/pathology;
Lymph Nodes/pathology;
Lymphatic Metastasis;
Male;
Mediastinum;
Middle Aged;
Neoplasm Staging;
Positron-Emission Tomography;
Predictive Value of Tests;
Radiopharmaceuticals/diagnostic use;
Sensitivity and Specificity;
Tomography, X-Ray Computed
- From:Journal of Korean Medical Science
2011;26(1):67-70
- CountryRepublic of Korea
- Language:English
-
Abstract:
Because tuberculous (TB) involvement of mediastinal lymph nodes (LN) could cause false positive results in nodal staging of lung cancer, we examined the accuracy of nodal staging in lung cancer patients with radiographic sequelae of healed TB. A total of 54 lung cancer patients with radiographic TB sequelae in the lung parenchyma ipsilateral to the resected lung, who had undergone at least ipsilateral 4- and 7-lymph node dissection after both chest computed tomography (CT) and fluorodeoxyglucose (FDG)-positron emission tomography (PET)/CT were included for the analysis. The median age of 54 subjects was 66 yr and 48 were males. Calcified nodules and fibrotic changes were the most common forms of healed parenchymal pulmonary TB. Enlarged mediastinal lymph nodes (short diameter > 1 cm) were identified in 21 patients and positive mediastinal lymph nodes were identified using FDG-PET/CT in 19 patients. The overall sensitivity and specificity for mediastinal node metastasis were 60.0% and 69.2% with CT and 46.7% and 69.2% with FDG-PET/CT, respectively. In conclusion, the accuracy of nodal staging using CT or FDG-PET/CT might be low in lung cancer patients with parenchymal TB sequelae, because of inactive TB lymph nodes without viable TB bacilli.
