Hilar lymphadenopathy, a novel finding in the setting of coronavirus disease (COVID-19): a case report.
Identifieur interne : 000539 ( Main/Exploration ); précédent : 000538; suivant : 000540Hilar lymphadenopathy, a novel finding in the setting of coronavirus disease (COVID-19): a case report.
Auteurs : Mohsin Sheraz Mughal [États-Unis] ; Rameez Rehman [États-Unis] ; Ramy Osman [États-Unis] ; Nathan Kan [États-Unis] ; Hasan Mirza [États-Unis] ; Margaret H. Eng [États-Unis]Source :
- Journal of medical case reports [ 1752-1947 ] ; 2020.
Descripteurs français
- KwdFr :
- Antienzymes (usage thérapeutique), Betacoronavirus (isolement et purification), Femelle (MeSH), Humains (MeSH), Hydroxychloroquine (usage thérapeutique), Infections à coronavirus (complications), Infections à coronavirus (traitement médicamenteux), Lymphadénopathie (imagerie diagnostique), Lymphadénopathie (traitement médicamenteux), Lymphadénopathie (étiologie), Pandémies (MeSH), Pneumopathie virale (complications), Pneumopathie virale (traitement médicamenteux), Poumon (imagerie diagnostique), Sujet âgé (MeSH), Tomodensitométrie (méthodes).
- MESH :
- imagerie diagnostique : Lymphadénopathie, Poumon.
- isolement et purification : Betacoronavirus.
- méthodes : Tomodensitométrie.
- traitement médicamenteux : Infections à coronavirus, Lymphadénopathie, Pneumopathie virale.
- usage thérapeutique : Antienzymes, Hydroxychloroquine, Infections à coronavirus, Pneumopathie virale.
- étiologie : Lymphadénopathie.
- Femelle, Humains, Pandémies, Sujet âgé.
English descriptors
- KwdEn :
- Aged (MeSH), Betacoronavirus (isolation & purification), Coronavirus Infections (complications), Coronavirus Infections (drug therapy), Enzyme Inhibitors (therapeutic use), Female (MeSH), Humans (MeSH), Hydroxychloroquine (therapeutic use), Lung (diagnostic imaging), Lymphadenopathy (diagnostic imaging), Lymphadenopathy (drug therapy), Lymphadenopathy (etiology), Pandemics (MeSH), Pneumonia, Viral (complications), Pneumonia, Viral (drug therapy), Tomography, X-Ray Computed (methods).
- MESH :
- chemical , therapeutic use : Enzyme Inhibitors, Hydroxychloroquine.
- complications : Coronavirus Infections, Pneumonia, Viral.
- diagnostic imaging : Lung, Lymphadenopathy.
- drug therapy : Coronavirus Infections, Lymphadenopathy, Pneumonia, Viral.
- etiology : Lymphadenopathy.
- isolation & purification : Betacoronavirus.
- methods : Tomography, X-Ray Computed.
- Aged, Female, Humans, Pandemics.
Abstract
BACKGROUND
As the outbreak of coronavirus disease 2019 (COVID-19) has progressed, computed tomography has emerged as an integral part of the diagnosis alongside reverse transcriptase-polymerase chain reaction assays. Frequently encountered imaging findings include peripheral airspace consolidations; bilateral ground-glass opacities; and, less commonly, cavitation. Hilar lymphadenopathy is a rarely reported finding in the setting of COVID-19.
CASE PRESENTATION
A 73-year-old Caucasian woman presented to our hospital with fever and fatigue. She had a maximum body temperature of 102.3 °F with lymphopenia and thrombocytopenia. She was diagnosed with severe acute respiratory syndrome coronavirus 2 infection on the basis of a positive result from a reverse transcriptase-polymerase chain reaction of a nasopharyngeal swab sample. Contrast-enhanced chest computed tomography revealed multifocal, subpleural ground-glass opacities with nodular consolidations bilaterally. Computed tomography also demonstrated atypical bilateral hilar lymphadenopathy, a rarely reported imaging feature of COVID-19. Chest computed tomography 1 month before the presentation did not show focal consolidations or lymphadenopathy. This indicated that the findings were due to the patient's severe acute respiratory syndrome coronavirus 2 infection. She received 5 days of oral hydroxychloroquine and experienced resolution of her symptoms.
CONCLUSION
Chest computed tomography has been used extensively to diagnose and characterize the distinguishing radiological findings associated with viral pneumonia. It has emerged as an integral part of the diagnosis of COVID-19 alongside reverse transcriptase-polymerase chain reaction assays. Clinicians must be aware of uncommon clinical and radiological findings in order to diagnose this entity. Hilar lymphadenopathy is commonly seen with fungal infections, mycobacterial infections, and sarcoidosis. An extensive literature review found that bilateral hilar lymphadenopathy has not been reported in the setting of COVID-19. More data are needed to establish the clinical impact of this novel finding.
DOI: 10.1186/s13256-020-02452-3
PubMed: 32771058
PubMed Central: PMC7415007
Affiliations:
Links toward previous steps (curation, corpus...)
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Eng</name><affiliation wicri:level="1"><nlm:affiliation>Monmouth Medical Center, An Affiliate of RWJ/Barnabas Health System, 300 2nd Avenue, Long Branch, NJ, 07740, USA.</nlm:affiliation><country xml:lang="fr">États-Unis</country><wicri:regionArea>Monmouth Medical Center, An Affiliate of RWJ/Barnabas Health System, 300 2nd Avenue, Long Branch, NJ, 07740</wicri:regionArea><wicri:noRegion>07740</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of medical case reports</title><idno type="eISSN">1752-1947</idno><imprint><date when="2020" type="published">2020</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged (MeSH)</term><term>Betacoronavirus (isolation & purification)</term><term>Coronavirus Infections (complications)</term><term>Coronavirus Infections (drug therapy)</term><term>Enzyme Inhibitors (therapeutic use)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Hydroxychloroquine (therapeutic use)</term><term>Lung (diagnostic imaging)</term><term>Lymphadenopathy (diagnostic imaging)</term><term>Lymphadenopathy (drug therapy)</term><term>Lymphadenopathy (etiology)</term><term>Pandemics (MeSH)</term><term>Pneumonia, Viral (complications)</term><term>Pneumonia, Viral (drug therapy)</term><term>Tomography, X-Ray Computed (methods)</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Antienzymes (usage thérapeutique)</term><term>Betacoronavirus (isolement et purification)</term><term>Femelle (MeSH)</term><term>Humains (MeSH)</term><term>Hydroxychloroquine (usage thérapeutique)</term><term>Infections à coronavirus (complications)</term><term>Infections à coronavirus (traitement médicamenteux)</term><term>Lymphadénopathie (imagerie diagnostique)</term><term>Lymphadénopathie (traitement médicamenteux)</term><term>Lymphadénopathie (étiologie)</term><term>Pandémies (MeSH)</term><term>Pneumopathie virale (complications)</term><term>Pneumopathie virale (traitement médicamenteux)</term><term>Poumon (imagerie diagnostique)</term><term>Sujet âgé (MeSH)</term><term>Tomodensitométrie (méthodes)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Enzyme Inhibitors</term><term>Hydroxychloroquine</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Coronavirus Infections</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Lung</term><term>Lymphadenopathy</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Coronavirus Infections</term><term>Lymphadenopathy</term><term>Pneumonia, Viral</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Lymphadenopathy</term></keywords><keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Lymphadénopathie</term><term>Poumon</term></keywords><keywords scheme="MESH" qualifier="isolation & purification" xml:lang="en"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="isolement et purification" xml:lang="fr"><term>Betacoronavirus</term></keywords><keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Tomography, X-Ray Computed</term></keywords><keywords scheme="MESH" qualifier="méthodes" xml:lang="fr"><term>Tomodensitométrie</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Infections à coronavirus</term><term>Lymphadénopathie</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antienzymes</term><term>Hydroxychloroquine</term><term>Infections à coronavirus</term><term>Pneumopathie virale</term></keywords><keywords scheme="MESH" qualifier="étiologie" xml:lang="fr"><term>Lymphadénopathie</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Aged</term><term>Female</term><term>Humans</term><term>Pandemics</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Femelle</term><term>Humains</term><term>Pandémies</term><term>Sujet âgé</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><p><b>BACKGROUND</b></p><p>As the outbreak of coronavirus disease 2019 (COVID-19) has progressed, computed tomography has emerged as an integral part of the diagnosis alongside reverse transcriptase-polymerase chain reaction assays. Frequently encountered imaging findings include peripheral airspace consolidations; bilateral ground-glass opacities; and, less commonly, cavitation. Hilar lymphadenopathy is a rarely reported finding in the setting of COVID-19.</p></div><div type="abstract" xml:lang="en"><p><b>CASE PRESENTATION</b></p><p>A 73-year-old Caucasian woman presented to our hospital with fever and fatigue. She had a maximum body temperature of 102.3 °F with lymphopenia and thrombocytopenia. She was diagnosed with severe acute respiratory syndrome coronavirus 2 infection on the basis of a positive result from a reverse transcriptase-polymerase chain reaction of a nasopharyngeal swab sample. Contrast-enhanced chest computed tomography revealed multifocal, subpleural ground-glass opacities with nodular consolidations bilaterally. Computed tomography also demonstrated atypical bilateral hilar lymphadenopathy, a rarely reported imaging feature of COVID-19. Chest computed tomography 1 month before the presentation did not show focal consolidations or lymphadenopathy. This indicated that the findings were due to the patient's severe acute respiratory syndrome coronavirus 2 infection. She received 5 days of oral hydroxychloroquine and experienced resolution of her symptoms.</p></div><div type="abstract" xml:lang="en"><p><b>CONCLUSION</b></p><p>Chest computed tomography has been used extensively to diagnose and characterize the distinguishing radiological findings associated with viral pneumonia. It has emerged as an integral part of the diagnosis of COVID-19 alongside reverse transcriptase-polymerase chain reaction assays. Clinicians must be aware of uncommon clinical and radiological findings in order to diagnose this entity. Hilar lymphadenopathy is commonly seen with fungal infections, mycobacterial infections, and sarcoidosis. An extensive literature review found that bilateral hilar lymphadenopathy has not been reported in the setting of COVID-19. More data are needed to establish the clinical impact of this novel finding.</p></div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">32771058</PMID><DateCompleted><Year>2020</Year><Month>08</Month><Day>24</Day></DateCompleted><DateRevised><Year>2020</Year><Month>08</Month><Day>24</Day></DateRevised><Article PubModel="Electronic"><Journal><ISSN IssnType="Electronic">1752-1947</ISSN><JournalIssue CitedMedium="Internet"><Volume>14</Volume><Issue>1</Issue><PubDate><Year>2020</Year><Month>Aug</Month><Day>09</Day></PubDate></JournalIssue><Title>Journal of medical case reports</Title><ISOAbbreviation>J Med Case Rep</ISOAbbreviation></Journal><ArticleTitle>Hilar lymphadenopathy, a novel finding in the setting of coronavirus disease (COVID-19): a case report.</ArticleTitle><Pagination><MedlinePgn>124</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1186/s13256-020-02452-3</ELocationID><Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">As the outbreak of coronavirus disease 2019 (COVID-19) has progressed, computed tomography has emerged as an integral part of the diagnosis alongside reverse transcriptase-polymerase chain reaction assays. Frequently encountered imaging findings include peripheral airspace consolidations; bilateral ground-glass opacities; and, less commonly, cavitation. Hilar lymphadenopathy is a rarely reported finding in the setting of COVID-19.</AbstractText><AbstractText Label="CASE PRESENTATION" NlmCategory="METHODS">A 73-year-old Caucasian woman presented to our hospital with fever and fatigue. She had a maximum body temperature of 102.3 °F with lymphopenia and thrombocytopenia. She was diagnosed with severe acute respiratory syndrome coronavirus 2 infection on the basis of a positive result from a reverse transcriptase-polymerase chain reaction of a nasopharyngeal swab sample. Contrast-enhanced chest computed tomography revealed multifocal, subpleural ground-glass opacities with nodular consolidations bilaterally. Computed tomography also demonstrated atypical bilateral hilar lymphadenopathy, a rarely reported imaging feature of COVID-19. Chest computed tomography 1 month before the presentation did not show focal consolidations or lymphadenopathy. This indicated that the findings were due to the patient's severe acute respiratory syndrome coronavirus 2 infection. She received 5 days of oral hydroxychloroquine and experienced resolution of her symptoms.</AbstractText><AbstractText Label="CONCLUSION" NlmCategory="CONCLUSIONS">Chest computed tomography has been used extensively to diagnose and characterize the distinguishing radiological findings associated with viral pneumonia. It has emerged as an integral part of the diagnosis of COVID-19 alongside reverse transcriptase-polymerase chain reaction assays. Clinicians must be aware of uncommon clinical and radiological findings in order to diagnose this entity. Hilar lymphadenopathy is commonly seen with fungal infections, mycobacterial infections, and sarcoidosis. An extensive literature review found that bilateral hilar lymphadenopathy has not been reported in the setting of COVID-19. More data are needed to establish the clinical impact of this novel finding.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Mughal</LastName><ForeName>Mohsin Sheraz</ForeName><Initials>MS</Initials><Identifier Source="ORCID">http://orcid.org/0000-0002-9718-0874</Identifier><AffiliationInfo><Affiliation>Monmouth Medical Center, An Affiliate of RWJ/Barnabas Health System, 300 2nd Avenue, Long Branch, NJ, 07740, USA. mohsinsherazmd@gmail.com.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Rehman</LastName><ForeName>Rameez</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Monmouth Medical Center, An Affiliate of RWJ/Barnabas Health System, 300 2nd Avenue, Long Branch, NJ, 07740, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Osman</LastName><ForeName>Ramy</ForeName><Initials>R</Initials><AffiliationInfo><Affiliation>Monmouth Medical Center, An Affiliate of RWJ/Barnabas Health System, 300 2nd Avenue, Long Branch, NJ, 07740, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Kan</LastName><ForeName>Nathan</ForeName><Initials>N</Initials><AffiliationInfo><Affiliation>Monmouth Medical Center, An Affiliate of RWJ/Barnabas Health System, 300 2nd Avenue, Long Branch, NJ, 07740, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Mirza</LastName><ForeName>Hasan</ForeName><Initials>H</Initials><AffiliationInfo><Affiliation>Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Eng</LastName><ForeName>Margaret H</ForeName><Initials>MH</Initials><AffiliationInfo><Affiliation>Monmouth Medical Center, An Affiliate of RWJ/Barnabas Health System, 300 2nd Avenue, Long Branch, NJ, 07740, USA.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D002363">Case Reports</PublicationType><PublicationType UI="D016428">Journal Article</PublicationType></PublicationTypeList><ArticleDate DateType="Electronic"><Year>2020</Year><Month>08</Month><Day>09</Day></ArticleDate></Article><MedlineJournalInfo><Country>England</Country><MedlineTA>J Med Case Rep</MedlineTA><NlmUniqueID>101293382</NlmUniqueID><ISSNLinking>1752-1947</ISSNLinking></MedlineJournalInfo><ChemicalList><Chemical><RegistryNumber>0</RegistryNumber><NameOfSubstance UI="D004791">Enzyme Inhibitors</NameOfSubstance></Chemical><Chemical><RegistryNumber>4QWG6N8QKH</RegistryNumber><NameOfSubstance UI="D006886">Hydroxychloroquine</NameOfSubstance></Chemical></ChemicalList><SupplMeshList><SupplMeshName Type="Disease" UI="C000657245">COVID-19</SupplMeshName><SupplMeshName Type="Organism" UI="C000656484">severe acute respiratory syndrome coronavirus 2</SupplMeshName></SupplMeshList><CitationSubset>IM</CitationSubset><MeshHeadingList><MeshHeading><DescriptorName UI="D000368" MajorTopicYN="N">Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D000073640" MajorTopicYN="N">Betacoronavirus</DescriptorName><QualifierName UI="Q000302" MajorTopicYN="Y">isolation & purification</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D018352" MajorTopicYN="N">Coronavirus Infections</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D004791" MajorTopicYN="N">Enzyme Inhibitors</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006886" MajorTopicYN="N">Hydroxychloroquine</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008168" MajorTopicYN="N">Lung</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="N">diagnostic imaging</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D000072281" MajorTopicYN="N">Lymphadenopathy</DescriptorName><QualifierName UI="Q000000981" MajorTopicYN="Y">diagnostic imaging</QualifierName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName><QualifierName UI="Q000209" MajorTopicYN="Y">etiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D058873" MajorTopicYN="N">Pandemics</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D011024" MajorTopicYN="N">Pneumonia, Viral</DescriptorName><QualifierName UI="Q000150" MajorTopicYN="Y">complications</QualifierName><QualifierName UI="Q000188" MajorTopicYN="N">drug therapy</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D014057" MajorTopicYN="N">Tomography, X-Ray Computed</DescriptorName><QualifierName UI="Q000379" MajorTopicYN="Y">methods</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="N">COVID-19</Keyword><Keyword MajorTopicYN="N">Coronavirus</Keyword><Keyword MajorTopicYN="N">Lymphadenopathy</Keyword><Keyword MajorTopicYN="N">Viral pneumonia</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="received"><Year>2020</Year><Month>04</Month><Day>09</Day></PubMedPubDate><PubMedPubDate PubStatus="accepted"><Year>2020</Year><Month>07</Month><Day>08</Day></PubMedPubDate><PubMedPubDate PubStatus="entrez"><Year>2020</Year><Month>8</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate PubStatus="pubmed"><Year>2020</Year><Month>8</Month><Day>11</Day><Hour>6</Hour><Minute>0</Minute></PubMedPubDate><PubMedPubDate 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IdType="pubmed">32101510</ArticleId></ArticleIdList></Reference><Reference><Citation>AJR Am J Roentgenol. 2020 Jul;215(1):87-93</Citation><ArticleIdList><ArticleId IdType="pubmed">32174129</ArticleId></ArticleIdList></Reference><Reference><Citation>MMWR Morb Mortal Wkly Rep. 2020 Feb 07;69(5):140-146</Citation><ArticleIdList><ArticleId IdType="pubmed">32027631</ArticleId></ArticleIdList></Reference><Reference><Citation>Radiology. 2020 Apr;295(1):202-207</Citation><ArticleIdList><ArticleId IdType="pubmed">32017661</ArticleId></ArticleIdList></Reference><Reference><Citation>Radiographics. 2018 May-Jun;38(3):719-739</Citation><ArticleIdList><ArticleId IdType="pubmed">29757717</ArticleId></ArticleIdList></Reference><Reference><Citation>J Infect Dis. 2020 May 11;221(11):1770-1774</Citation><ArticleIdList><ArticleId IdType="pubmed">32179910</ArticleId></ArticleIdList></Reference><Reference><Citation>Radiology. 2020 Jun;295(3):715-721</Citation><ArticleIdList><ArticleId IdType="pubmed">32053470</ArticleId></ArticleIdList></Reference><Reference><Citation>Radiology. 2020 Aug;296(2):E41-E45</Citation><ArticleIdList><ArticleId IdType="pubmed">32049601</ArticleId></ArticleIdList></Reference></ReferenceList></PubmedData></pubmed><affiliations><list><country><li>États-Unis</li></country><region><li>Massachusetts</li></region></list><tree><country name="États-Unis"><noRegion><name sortKey="Mughal, Mohsin Sheraz" sort="Mughal, Mohsin Sheraz" uniqKey="Mughal M" first="Mohsin Sheraz" last="Mughal">Mohsin Sheraz Mughal</name></noRegion><name sortKey="Eng, Margaret H" sort="Eng, Margaret H" uniqKey="Eng M" first="Margaret H" last="Eng">Margaret H. Eng</name><name sortKey="Kan, Nathan" sort="Kan, Nathan" uniqKey="Kan N" first="Nathan" last="Kan">Nathan Kan</name><name sortKey="Mirza, Hasan" sort="Mirza, Hasan" uniqKey="Mirza H" first="Hasan" last="Mirza">Hasan Mirza</name><name sortKey="Osman, Ramy" sort="Osman, Ramy" uniqKey="Osman R" first="Ramy" last="Osman">Ramy Osman</name><name sortKey="Rehman, Rameez" sort="Rehman, Rameez" uniqKey="Rehman R" first="Rameez" last="Rehman">Rameez Rehman</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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