Correlation between CT finding and mediastinoscopic biopsy results for diagnosis of mediastinal lymphadenopathy

Abstract

Background Mediastinal lesions are difficult to detect on radiograph because these lesions are of soft tissue densities and are surrounded by soft tissue structures. Here is where computed tomography (CT) can provide the answer. It provides information on the anatomical extent of the lesion and the nature of the lesion. Aim The aim of this work is to evaluate the possibility of anticipation of histopathological tissue diagnosis for a mediastinal lymphadenopathy specimen taken by mediastinoscopy on the basis of preoperative CT findings for patients admitted in Al-Zahraa University Hospital in the Cardiothoracic Surgery Department. Patients and methods Thirty patients were included in this study, admitted in the Cardiothoracic Surgery Department of Al-Zahraa University Hospital from December 2019 to May 2020. All patients had received a diagnosis by CT chest and invasive method in the form of mediastinoscopy; then, histopathological results of the mediastinoscopic biopsy were correlated with the CT chest finding to estimate the relationship between both methods of diagnosis in cases with mediastinal lymphadenopathy. Results There is no definitive sign in CT imaging either using the size or shape or distribution to help in reaching the final diagnosis. Therefore, the biopsy is inevitable in all cases. Conclusion The CT remains the most important noninvasive tool for the diagnosis of mediastinal lymphadenopathies with good sensitivity, specificity, and diagnostic accuracy. Despite this, it does not exceed the prediction, and the cause of lymphadenopathy must be diagnosed to be able to start the appropriate treatment.