MEDIASTINAL LYMPH NODES IN HEALTHY CHILDREN; FREQUENCY, SIZE RANGE AND DISTRIBUTION BY AGE

Yıl 2020, Cilt: 83 Sayı: 1, 1 - 9, 13.01.2020

Zuhal Bayramoğlu Ensar Yekeler

https://doi.org/10.26650/IUITFD.2019.0087

Öz

Objective: Decision making about clinically significant lymph nodes (LN) is crucial. We elaborated the mediastinal LNs based on location, size and age groups. Material and Method: Contrast enhanced chest computed tomography scans of 150 children who were referred to the radiology department after trauma, were evaluated retrospectively. All participants were divided into five age groups (0-24, 25-60, 61120, 121-180 and 181-216 months) which included thirty children each. We documented the shortest and longest axis diameters of the largest LNs and their location along with the age and gender of the children. Kolmogorov-Smirnov test, t test, Spearman’s correlation analysis assessment and descriptive statistics were expressed using SPSS 22. Results: Mean ages were 11.53±10.1, 39.4±11.1, 84±15.9, 154.9±17.6, 190±9.3 months in consecutive age groups and 96±69.17 months in general. The most frequent locations with detectable LNs were subcarinal (n:98, 64%), right lower paratracheal (n:88, 57%), right tracheobronchial (n:82, 56%), right upper paratracheal (n:75, 49%) and left tracheobronchial (n:61, %39) lymphatic stations. Mean short and long axis diameters were 3.97±1mm (interquartile range:3.4-5.2) and 7.48±1.98mm (interquartile range:6.3-9.1) among detected 648 LNs, respectively. Both short and long axis diameters of LNs in low cervical, prevascular, subcarinal, right-left paratracheal and right-left tracheobronchial locations were correlated with the age (p<0.05). Both short and long axis diameters of subcarinal LNs (4.78±1.05mm, 9.30±1.8mm) were significantly larger than right lower paratracheal (4.03±0.9mm, 7.94±1.6mm; p:0.001), right tracheobronchial (4.42±1.26mm, 8.59±2.1mm; p:0.04) and right upper paratracheal LNs (3.64±0.79mm, 7.1±1.49mm). Conclusion: Being aware of the size range for normal mediastinal LNs according to ages and locations would facilitate management and reduce unnecessary interventions and medications.

Anahtar Kelimeler

Children, lymph node, mediastinum, computed tomography

SAĞLIKLI ÇOCUKLARDA MEDİASTİNAL LENF GANGLİONLARI; YAŞA GÖRE SIKLIK, BOYUT ARALIĞI VE DAĞILIM

Öz

Amaç: Klinik olarak anlamlı lenf nodları (LN) hakkında karar vermek çok önemlidir. Mediastinal LNları lokasyon, boyut ve yaş gruplarına göre değerlendirdik. Gereç ve Yöntem: Travma sonrası radyoloji bölümüne yönlendirilen 150 çocuğun kontrastlı göğüs bilgisayarlı tomografi taramaları retrospektif olarak değerlendirildi. Tüm katılımcılar her biri otuz çocuğu içeren beş yaş grubuna ayrıldı (0-24, 25-60, 61-120, 121-180 ve 181-216 ay). En büyük LNlarının kısa ve uzun eksendeki çapları konumları, yaş ve cinsiyetlerine göre değerlendirildi. SPSS 22 programı ile Kolmogorov-Smirnov testi, t testi, Spearman korelasyon analizi ve tanımlayıcı istatistikler çalışıldı. Bulgular: Ortalama yaş, gruplarda sırasıyla 11,53±10,1 ay, 39,4±11,1 ay, 84±15,9 ay, 154,9±17,6 ay, 190±9,3 ay ve toplamda 96±69,17 aydı. LN’larının en sık görüldüğü lokasyonlar subkarinal (n:98, %64), sağ alt paratrakeal (n:88, %57), sağ trakeobronşiyal (n:82, %56), sağ üst paratrakeal (n:75, %49) ve sol trakeobronşiyal (n:61, % 39) lenfatik istasyonlardı. Ortalama kısa ve uzun eksen çapları sırasıyla 647 LN arasında 3.97±1mm (çeyrekler arası aralık: 3,4-5,2) ve 7,48±1,98mm (çeyrekler arası aralık: 6,3-9,1) idi. Alt servikal, prevasküler, subkarinal, sağ-sol paratrakeal ve sağ-sol trakeobronşiyal lokasyonlarda LNlarının hem kısa hem de uzun eksen çapları yaşla korele idi (p<0,05). Subkarinal LN’larının kısa ve uzun eksen çapları (4,78±1,05 mm, 9,30±1,8mm) sağ alt paratrakeal (4,03±0,9mm, 7,94±1,6mm; p:0,001), sağ trakeobronşiyal (4,42±1,26mm, 8,59±2,1mm; p:0,04) ve sağ üst paratrakeal LN’lerden (3,64±0,79mm, 7.1±1,49mm) anlamlı derecede büyüktü. Sonuç: Yaş ve yerleşime göre normal mediastinal LN’lerin boyut aralığının farkında olmak hasta yönetimi kolaylaştırır, gereksiz müdahaleleri ve ilaç kullanımını azaltır.

Anahtar Kelimeler

Çocuklar, lenf bezi, mediasten, bilgisayarlı tomografi

Kaynakça

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