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Free Content Tuberculosis vs. chronic lymphocytic leukaemia in mediastinal lymph nodes using computed tomography

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BACKGROUND: The enlarged mediastinal lymph nodes caused by tuberculosis (TB) and chronic lymphocytic leukaemia (CLL) are similar, sometimes resulting in misdiagnosis of the two diseases.

OBJECTIVE: To determine the differential characteristics of enlarged mediastinal lymph nodes caused by TB and CLL using multidetector-row computed tomography (MDCT).

MATERIALS AND METHODS: We conducted a retrospective analysis for the anatomical distribution and enhancement patterns of mediastinal lymph nodes on MDCT in 67 consecutive patients with newly diagnosed untreated TB (58%) and CLL (42%).

RESULTS: Concerning the main anatomic distribution of lymph nodes, TB involved the 4R (n = 32, 82%) and 10R (n = 27, 69%) regions more often than CLL (n = 16, 57%; n = 12, 43%, respectively). Contrast region 1 had a greater tendency to be affected in CLL (n = 16, 57%) than TB (n = 11, 28%). TB showed peripheral enhancement in 28 cases (72%), frequently with a multilocular appearance, compared to CLL, which showed no peripheral enhancement in these cases. Homogeneous enhancement was more commonly seen in CLL than in TB (82% vs. 10%, P < 0.01).

CONCLUSION: The distribution and enhancement pattern of enlarged lymph nodes on MDCT was useful in differentiating TB and CLL.

Keywords: CLL; TB; computed tomography; mediastinal lymph node

Document Type: Research Article


Affiliations: 1: State Key Laboratory of Biotherapy, and Department of Radiology, West China Hospital of Sichuan University, Chengdu, Sichuan, China 2: State Key Laboratory of Biotherapy, West China Hospital of Sichuan University, Chengdu, Sichuan, China

Publication date: 2014-02-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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