Objective: To determine whether the computed tomographic (CT) characteristics of benign intrapulmonary lymph nodes and small sarcoma metastases are sufficiently characteristic to allow specific prospective identification. Patients and Methods: Preoperative chest CT scans of 41 patients with benign intrapulmonary lymph nodes and 33 patients with sarcoma metastases seen from 1991 through 1996 were retrospectively reviewed and correlated with pathologic findings. Results: Fifty-seven benign intrapulmonary lymph nodes were found. Twenty-six (46%) were subpleural, 38 (67%) were oval, and 46 (81%) were located in the lower portions of the lungs; 43 (75%) had a lymphatic distribution on CT and 54 (95%) at pathologic review. Ninety-eight sarcoma metastases were found. Thirteen (13%) were subpleural, 15 (15%) were oval, and 56 (57%) were in the lower portions of the lungs; 29 (30%) had a lymphatic distribution on CT and 45 (46%) at pathologic review. Conclusion: Benign intrapulmonary lymph nodes were more likely than sarcoma metastases to be oval, to occur in a lymphatic distribution, and to be located subpleurally.
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