Abstract
Introduction: There is a lack of data on chest computed tomography (CT) findings on mediastinal lymph node enlargement (MLE), including normal size threshold of less than 10 or 15 mm for MLE among Indigenous Australians. In this study, we assessed the significance and the applicability of the current guidelines for the threshold for abnormal MLE among adult Indigenous Australians.
Methods: Patients who underwent chest CT between 2012 and 2020 among those referred to undergo lung function test (spirometry) were assessed for the presence of MLE which were classified as Group A (no measurable nodes), Group B (<10 mm), Group C (≥10 to 14.99 mm) and Group D (≥15 mm).
Results: Of the total 67 patients identified to have MLE, 49 patients had at least two CT scans available for assessment over a median follow-up period of 101.3 weeks (IQR: 62.4, 235.6) and were included in the analysis. Evidence of chronic lung disease was common, with a significant proportion demonstrating either COPD or bronchiectasis and a high proportion with smoking history (93%). During the first CT scan, 34/49 (69%) had >10 mm nodes, of which 12/34 (35%) reduced in size, 22/34 (65%) remained stable, and 3/34 (9%) had malignancy on follow-up.
Conclusion: Despite most patients demonstrating the presence of significant MLE with varying size and in most >10 mm, the majority remain stable or benign in nature and only a minor proportion showed evidence of lung malignancy. Further prospective studies are needed in the characterisation of MLE among Indigenous patients.
| Original language | English |
|---|---|
| Pages (from-to) | 726-733 |
| Number of pages | 8 |
| Journal | Journal of Medical Imaging and Radiation Oncology |
| Volume | 67 |
| Early online date | 21 Jul 2023 |
| DOIs | |
| Publication status | Published - Oct 2023 |
Bibliographical note
Funding Information:We would like to thank our respiratory clinical nurse consultants, Mrs Raelene Messenger and Mrs Siji Issac from the respiratory chronic disease unit, at the RDH, including, rural and remote community Aboriginal health workers and RDH patients travel division for coordinating care for Aboriginal people living in the remote and rural communities. We also would like to thank our research assistant Ms Ara Perez for the data collection. We also extend our sincere appreciation to our Aboriginal health worker, Mr Izaak Thomas (Australian Indigenous Luritja descendent) from the respiratory chronic respiratory disease co-ordination division for reviewing this research, addressing much-needed data in the diagnosis and management of adult Aboriginal patients with respiratory disorders and for the appropriateness and respect in relation to the Aboriginal context represented in this study. Open access publishing facilitated by Flinders University, as part of the Wiley - Flinders University agreement via the Council of Australian University Librarians.
Publisher Copyright:
© 2023 The Authors. Journal of Medical Imaging and Radiation Oncology published by John Wiley & Sons Australia, Ltd on behalf of Royal Australian and New Zealand College of Radiologists.
