Cardiac Sarcoidosis Underlies Idiopathic Dilated Cardiomyopathy Importance of Mediastinal Lymphadenopathy in Differential Diagnosis

• Otsuka Kaoru

  Department of Internal Medicine III, Osaka Medical College

• Terasaki Fumio

  Department of Internal Medicine III, Osaka Medical College

• Eishi Yoshinobu

  Department of Pathology, Tokyo Medical and Dental University, School of Medicine

• Shimomura Hiroaki

  Department of Internal Medicine III, Osaka Medical College

• Ogura Yasuharu

  Department of Radiology, Osaka Medical College

• Horii Taiko

  First Department of Surgery, Kagawa University School of Medicine

• Isomura Tadashi

  Department of Cardiovascular Surgery, Hayama Heart Center

• Suma Hisayoshi

  Department of Cardiovascular Surgery, The Cardiovascular Institute Hospital

• Kitaura Yasushi

  Department of Internal Medicine III, Osaka Medical College

書誌事項

タイトル別名

• Importance of Mediastinal Lymphadenopathy in Differential Diagnosis

抄録

Background Cardiac sarcoidosis is frequently overlooked or misdiagnosed as idiopathic dilated cardiomyopathy (DCM), primarily because of difficulties in its diagnosis. This is a crucial issue because appropriate therapy with immunosuppressive agents can be initiated if early diagnosis is achieved. Methods and Results Thoracic computed tomography (CT) was retrospectively analyzed in detail with special reference to lymph node swelling (LNS) in the mediastinum of 8 patients diagnosed with idiopathic DCM who underwent left ventriculoplasty (LVP), and were later proven to have active cardiac sarcoidosis by histological evaluation of the resected myocardium. Twenty age-matched patients with idiopathic DCM who also underwent LVP served as controls. On conventional chest radiographs, none of the cardiac sarcoidosis patients exhibited lymph node involvement, including bilateral hilar lymphadenopathy. However, CT demonstrated significant mediastinal LNS in 7 (88%) of them and in only 1 (5%) of the 20 controls. There was a significant difference in the incidence of LNS in the 2 groups (p=0.00005). Conclusion Evaluation of mediastinal lymphadenopathy by CT is an easy and valuable initial screening method for distinguishing cardiac sarcoidosis from idiopathic DCM. (Circ J 2007; 71: 1937 - 1941)<br>

収録刊行物

• Circulation Journal

  Circulation Journal 71 (12), 1937-1941, 2007

  一般社団法人 日本循環器学会

キーワード

• Cardiac sarcoidosis
• Computed tomography
• Mediastinal lymphadenopathy

詳細情報

• CRID: 1390282680081263488
• NII論文ID: 110006452880
• NII書誌ID: AA11591968
• DOI: 10.1253/circj.71.1937
• ISSN: 13474820
• ISSN: 13469843
• Web Site: http://www.jstage.jst.go.jp/article/circj/71/12/71_12_1937/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2008116757
• 本文言語コード: en
• データソース種別:
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  • Crossref
  • CiNii Articles
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