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Chest Imaging and Pathology for Clinicians |

A 70-Year-Old Man With Large Cervical and Mediastinal LymphadenopathiesCervical and Mediastinal Lymphadenopathy

Shraddha Narechania, MD; Jason Valent, MD; Carol Farver, MD; Adriano R. Tonelli, MD
Author and Funding Information

From Internal Medicine (Dr Narechania), Fairview Hospital; and the Department of Hematology and Oncology (Dr Valent), the Department of Anatomic Pathology (Dr Farver), and the Department of Pulmonary, Allergy and Critical Care Medicine, Respiratory Institute (Dr Tonelli), Cleveland Clinic, Cleveland, OH.

CORRESPONDENCE TO: Adriano R. Tonelli, MD, 9500 Euclid Ave A-90, Cleveland, OH 44195; e-mail: tonella@ccf.org


FUNDING/SUPPORT: Dr Tonelli is supported by CTSA KL2 [Grant RR024990] from the National Center for Research Resources (NCRR), a component of the National Institutes of Health (NIH), and by the NIH Roadmap for Medical Research.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2015;148(1):e8-e13. doi:10.1378/chest.14-3124
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We present a case of a 70-year-old man with enlarged mediastinal and cervical lymph nodes that provided interesting radiologic and pathologic observations. The 70-year-old black man was found to have enlarged mediastinal lymph nodes. He had symptoms of atypical chest pain and generalized weakness for 2 weeks prior to the diagnosis. He denied shortness of breath, fever, chills, or night sweats. He was treated for hypertension and onychomycosis. Basic laboratory findings were within normal limits. Pulmonary function tests at the time of presentation showed FEV1, FVC, and FEV1/FVC ratio of 123% predicted, 133% predicted, and 0.7, respectively. Meanwhile, total lung capacity and carbon monoxide diffusing capacity were 103% and 107% predicted, respectively. Two weeks before he presented to our institution, the patient underwent bronchoscopy with transbronchial biopsies of the right lower lobe and endobronchial ultrasound-guided transbronchial needle aspiration of the right hilar lymph nodes.

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