Clinical and radiographic predictors of the etiology of computed tomography-diagnosed intrathoracic lymphadenopathy in HIV-infected patients

Robert M. Jasmer, Michael B. Gotway, Jennifer M. Creasman, W. Richard Webb, Keith J. Edinburgh, Laurence Huang

Research output: Contribution to journalArticle

27 Scopus citations

Abstract

In HIV-infected patients with intrathoracic lymphadenopathy, it is not known whether clinical and radiographic findings are useful in predicting a specific diagnosis. We determined the etiology and predictors of the etiology of computed tomography (CT)-diagnosed intrathoracic lymphadenopathy in HIV-infected patients evaluated from June 1993 through April 1999. Multivariate analyses were performed to determine clinical and radiographic predictors of the three most common diagnoses. Of 318 patients, 110 (35%) had lymphadenopathy on chest CT. Among these 110 patients, tuberculosis/nontuberculous mycobacterial disease (n = 31), bacterial pneumonia (n = 26), and lymphoma (n = 21) were the most common diagnoses. Multivariate analysis identified cough and necrosis of lymph nodes on chest CT as independent predictors of tuberculosis/nontuberculous mycobacterial disease. African-American race, symptoms for 1 to 7 days, dyspnea, and presence of airways disease on chest CT were independent predictors of bacterial pneumonia; symptoms for <7 days, absence of cough, and absence of pulmonary nodules on CT independently predicted lymphoma. Intrathoracic lymphadenopathy is a frequent chest CT finding in HIV-infected patients. Opportunistic infections and lymphoma are the most common causes, and specific clinical and radiographic features can suggest these particular diagnoses.

Original languageEnglish (US)
Pages (from-to)291-298
Number of pages8
JournalJournal of Acquired Immune Deficiency Syndromes
Volume31
Issue number3
DOIs
StatePublished - Nov 1 2002

Keywords

  • AIDS
  • Bacterial pneumonia
  • Computed tomography
  • HIV infection
  • Lymphadenopathy thorax
  • Opportunistic infection
  • Pulmonary disease

ASJC Scopus subject areas

  • Infectious Diseases
  • Pharmacology (medical)

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