Discussion
Diagnosis With Brief Discussion
- Diagnosis
- Lung, RUL, wedge resection; Intrapulmonary lymph node
- Radiologic Findings
- Simple Radiography:
No remarkable evidence of active pulmonary infiltrations.
Pleural and mediastinal abnormalities are not definite.
CT scan:
Initial chest CT scan revealed non calcified subpleural nodule (8mm).
Follow up scan in 3mo showed no remarkable interval growth of RUL nodule.
Differential diagnoses include bronchioloaveolar carcinoma, atypical adenomatous hyperplasia, focal fibrosis
Wedge biopsy reveals intrapulmonary lymph node.
- Brief Review
- Intrapulmonary lymph node (IPLN) is in the differential diagnosis of small pulmonary nodules detected on computed tomography (CT)[1-4]. It is detected in lung cancer patients and those without lung cancer [2-4]. Bankoff et al. [5] and others reported that IPLN is usually 12 mm or smaller in diameter and is located in the subpleural portion of the lower lung [1-2].
CT findings of IPLN are not specific, the distinction from malignant nodules is difficult.
Other investigators reported interesting findings of IPLN using high-resolution CT (HRCT), such as an angular appearance in shape and linear opacities extending from the nodule[2,8,9].
- References
- 1. Ishikawa, Koizumi, Naoya, Morita, et al. Ultrasmall Intrapulmonary Lymph Node: Usual High-Resolution Computed Tomographic Findings With Histopathologic Correlation. J Comput Ass Tomogr. 2007 May-Jun;31(3):409-13.
2. Kradin RL, Spirn PW, Mark EJ. Intrapulmonary lymph nodes. Clinical, radiologic, and pathologic features. Chest. 1985;87:662-667.
3. Fujimoto N, Segewa Y, Takigawa N, et al. Two cases of intrapulmonary lymph node presenting as a peripheral nodular shadow: diagnostic differentiation from lung cancer. Lung Cancer. 1998;20:203-209.
4. Oshiro Y, Kusumoto M, Moriyama N, et al. Intrapulmonary lymph nodes: thin-section CT features of 19 nodules. J Comput Assist Tomogr. 2002;26:553-557.
5. Bankoff MS, McEniff NJ, Bhadelia RA, et al. Prevalence of pathologically proven intrapulmonary lymph nodes and their appearance on CT. AJR Am J Roentgenol. 1996;167:629-630.
6. Trapnell DH. Recognition and incidence of intrapulmonary lymph nodes. Thorax. 1964;19:44-50.
7. Kunitoh H, Eguchi K, Yamada K, et al. Intrapulmonary sublesions detected before surgery in patients with lung cancer. Cancer. 1992;70:1876-1879.
8. Awai K, Nishioka Y, Tachiyama Y. Intrapulmonary lymph node: findings on high-resolution CT scans. AJR Am J Roentgenol. 1993;161:208-209.
9. Hyodo T, Kanazawa S, Dendo S, et al. Intrapulmonary lymph nodes: thin-section CT findings, pathological findings, and CT differential diagnosis from pulmonary metastatic nodules. Acta Med Okayama. 2004;58:235-240.
- Keywords
- Lung, Lymphoid hyperplasia,