MEDIASTINAL LYMPHADENOPATHY IN CRYPTOGENIC FIBROSING ALVEOLITIS - THEEFFECT OF STEROID-THERAPY ON THE PREVALENCE OF NODAL ENLARGEMENT

Purpose: To determine the prevalence of enlarged mediastinal lymph nod es in cryptogenic fibrosing alveolitis (CFA) and to assess whether thi s frequency was related to steroid administration, Material and Method s: Retrospective review of chest radiographs and high-resolution compu ted tomography (CT) of 54 patients with proven cryptogenic fibrosing a lveolitis (CFA), Twenty-two of the 54 patients received oral steroids up to 2 months before the time of high-resolution CT examination (grou p 1); the remaining 32 patients had not taken steroids for at least 6 months before study entry (group 2), The prevalence, distribution, and size of enlarged mediastinal lymph nodes was determined in all groups . The diagnosis of CFA was histologically established in 44 patients, In 10 patients the diagnosis of CFA was based on clinical and high-res olution CT findings, Results: Mediastinal lymphadenopathy was present in 26 of 54 patients with CFA, The prevalence of enlarged nodes was 14 % (three of 22) in patients who had received oral steroids up to 2 mon ths before the time of CT examination, and 71% (23 of 32) in patients that had not taken steroids for at least 6 months before study entry. Conclusion: We conclude that patients with CFA on steroid therapy had a significantly lower prevalence of mediastinal adenopathy (P < 0.001) than patients who had not taken steroids.