Extra-Parenchymal Chest HRCT Findings in Patients with Systemic Sclerosis at the Time of Initial Diagnosis

Abstract

Objective:In systemic sclerosis (SS) patients who are receiving treatment, findings of extra-parenchymal chest involvement (such as thymic abnormality, mediastinal lymph node enlargement) have been previously examined. However, these findings may be affected by medical treatment. Our aim was to evaluate the extra-parenchymal chest high-resolution computed tomography (HRCT) findings of patients with SS at the time of initial diagnosis. Methods:We retrospectively analyzed medical database of patients with SS. Chest HRCT images within 1 month after initial diagnosis of these patients were re-evaluated for the presence of distal esophageal dilatation, thymic hyperplasia, mediastinal lymph node enlargement, pleural or pericardial abnormalities (effusion or thickening). Intergroup comparisons were performed using independent t-test or a Mann-Whitney U test. To detect the relationship between continuous variables, Spearman’s correlation coefficients and univariate correlations were used.Results:A total of 51 patients (45 women and 6 men, mean age + STD; 49.2 years+13.9) with SS were included in the study. Esophageal dilatation (88.2%) was the most common finding. Six patients (11.8%) had thymic enlargement. Mediastinal lymph node enlargement (11.8%) and pleural abnormalities (11.8%) were significantly more common in patients with SS diagnosed at late age (p<0.05).Conclusion:The extra-parenchymal findings are common in patients with SS at the time of initial diagnosis. Esophageal dilatation is usually present at the time of diagnosis in most patients with SS regardless of age.

Keywords

• Systemic sclerosis
• scleroderma
• high-resolution computed tomography
• thymus
• lymph node