Objective: To evaluate the relationship between mediastinal lymph node enla
rgement and disease severity score in patients with pulmonary fibrosis.
Materials and Methods: A retrospective study included 30 patients with pulm
onary fibrosis: idiopathic pulmonary fibrosis (n = 25), usual interstitial
pneumonia (UIP) associated with collagen vascular disease (n = 4), and UIP
associated with hepatitis C (n = 1). Disease severity was determined by a c
omputed tomography (CT) scoring system. Each patient's lobe was scored by t
wo radiologists on a scale of 0-5 for both ground glass opacity (GGO) and f
ibrosis. The presence, number, and sites of enlarged nodes (short axis grea
ter than or equal to 10 mm) were assessed. CT severity scores were compared
with total number of enlarged lymph nodes (L/Ns) and short axis diameter o
f the largest L/N (LLN). According to each severity score, patients were di
vided into two groups: the GGO-predominant group (n = 10) and the fibrosis-
predominant group (n = 20). Total numbers of enlarged L/Ns and short axis d
iameter of LLN were compared in each group.
Results: Enlarged mediastinal L/Ns were present in 86%. Total severity scor
e, GGO score, and fibrosis score strongly correlated with total number of e
nlarged L/Ns (p < 0.05). Total severity score and GGO score correlated well
with short axis diameter of LLN; however, the fibrosis score did not corre
late with the short axis diameter of LLN. In respect to total number of enl
arged L/Ns, the difference between the GGO group and fibrosis group was not
apparent. In respect to the short axis diameter of LLN, the GGO group LLN
was larger in diameter than the fibrosis group LLN (p < 0.05).
Conclusion: The greater the severity score of pulmonary fibrosis, the large
r the total number of enlarged L/Ns. Those patients with more GGO had large
r lymph nodes.