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Monday, March 30, 2015
Calcified Right Paratracheal/Azygous Node
Thank you for answering my question. I would like to know what happens if this condition is cancerous?
Question:Tell me about a calcified rt paratracheal/azygous node. I have one and am getting a CATscan (Petscan?)to see if it is active or not. What does this mean to me
Answer:Lymph nodes are the same as the "glands" in the neck that can become swollen when people get respiratory infections. The lymph nodes in the chest are mostly in the mediastinum, which is the center part of the chest. A lymph node that is "paratracheal" means that it is next to the trachea (the main windpipe). Lymph nodes in the chest commonly become enlarged due to previous chest infections. The most common infections that cause lymph nodes to become enlarged are histoplasmosis (if you have traveled to or live in the Midwestern or Southern United States) and tuberculosis. If lymph nodes remain enlarged for a long time, they can get calcium in them. Although lymph nodes can also become enlarged due to cancer, cancer does not cause calcium to be deposited in the lymph nodes. Therefore, if the lymph node contains calcium throughout the entire node, it is due to previous infection and not cancer. Most people who live in the Midwestern or Southern United States will get infected with histoplasmosis at some point in their life (but in most people, the infection is so mild that they have little or no symptoms). We normally do nothing with calcified lymph nodes from histoplasmosis and these nodes rarely cause symptoms. It is generally a good idea to get a tuberculosis test to be sure that the calcified lymph node is not from previous TB since that would necessitate treatment.
Lymph nodes that are fully calcified are benign and not cancerous. In this situation, we do not biopsy the lymph node and it does not require any further testing or treatment. Lymph nodes that are not calcified can be either benign or cancerous. If a patient has risks for cancer and has a large non-calcified lymph node, the node can be biopsied by a number of techniques including mediastinoscopy, ultrasound-guided bronchoscopy, or CT-guided needle biopsy. The biopsy is used to determine if it is cancerous and if so, what kind of cancer it is in order to direct treatment.
James N Allen, Jr, MD
Clinical Professor of Pulmonary, Allergy, Critical Care & Sleep Medicine
College of Medicine
The Ohio State University