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Index / Incidental findings

Incidental mediastinal lymph node

ACR 2018CT
Flowchart · click to enlarge
Incidental, asymptomatic mediastinal lymph node

Asymptomatic patient with an incidental mediastinal node on chest CT. Short axis 15 mm is the threshold.

  • < 15 mm short axis or benign features: no further work-up.
  • ≥ 15 mm with an explaining disease (emphysema, ILD, sarcoidosis, heart failure): manage the disease.
  • ≥ 15 mm unexplained: clinical consultation, PET/CT or chest CT in 3–6 months; biopsy or PET/CT if enlarging.

Sources

  1. Munden RF, Carter BW, Chiles C, et al. Managing incidental findings on thoracic CT: mediastinal and cardiovascular findings. A white paper of the ACR Incidental Findings Committee. J Am Coll Radiol. 2018;15:1087–1096.PubMed ↗
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Radessential summarizes published classification systems for practicing radiologists. Summaries are condensed; confirm details against the cited source before relying on them for patient care.