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Prevalence of Venoatrial Compression by Lymphadenopathy in Sarcoidosis

Gomes, Matthieu MD*; Bendaoud, Sofiane MD*; Wemeau-Stervinou, Lidwine MD; Faivre, Jean-Baptiste MD*; Duhamel, Alain PhD; Wallaert, Benoit MD; Remy, Jacques MD*; Remy-Jardin, Martine MD, PhD*

doi: 10.1097/RTI.0000000000000134
Original Articles
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Purpose: The purpose of the study was to evaluate the prevalence of compressive lymphadenopathy on pulmonary veins (PV) and left atrium (LA) in patients with sarcoidosis.

Materials and Methods: A total of 101 consecutive patients underwent a chest computed tomography angiographic examination with specific analysis of: (a) 3 nodal stations (ie, 7, 8, and 9 stations) for detection of LA compression; (b) 2 nodal stations (ie, 10 and 11 right and left stations) for detection of PV compression.

Results: Lymphadenopathy was present in 64 patients (64/101; 63.4%) with computed tomography features of venoatrial compression in 17 patients (17/101; 16.8%). This subgroup included 10 patients with LA compression alone (10/64; 15.6%), 6 patients with PV compression alone (6/64; 9.4%), and 1 patient with both (1/64; 1.5%). The mean diameter of enlarged lymph nodes compressing the LA and PVs was 3.18±0.73 cm (range: 2.1 to 4.4 cm) and 1.9±0.45 cm (range: 1 to 2.9 cm), respectively. PV compression was depicted in a total of 7 patients (7/101; 6.9%), observed as a unilateral (n=5) or bilateral (n=2) finding, with a mean number of 3.0 PVs compressed per patient (range: 1 to 7). A total of 10 venous sections showed features of compression, at the level of a lobar confluence (n=6) or individual segmental veins (V6; n=4), with a mean reduction in the venous cross-sectional area of 51.09%±12.85% (median: 50.06%). Nonfibrotic lung infiltration associated with sarcoidosis was observed in 88.2% of patients with compressive lymphadenopathy (15/17).

Conclusions: The prevalence of venoatrial compression in sarcoidosis is 16.8% in the studied population.

*Department of Thoracic Imaging, Hospital Calmette (EA 2694)

Department of Pulmonology, Centre of Rare Pulmonary Diseases

Department of Biostatistics (EA 2694), CHRU et Université de Lille 2 Nord de France, Lille, France

The authors declare no conflicts of interest.

Correspondence to: Martine Remy-Jardin, MD, PhD, Department of Thoracic Imaging, Hospital Calmette (EA 2694), CHRU et Université de Lille 2 Nord de France, F-59000 Lille, France (e-mail: martine.remy@chru-lille.fr).

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