Chest CT incidentalomas: thyroid lesions, enlarged mediastinal lymph nodes, and lung nodules

Abstract A computed tomography (CT) incidentaloma is an incidentally detected and previously unsuspected finding or abnormality that is not related to the indication for obtaining the CT examination. The aim of this article is to review the frequency of incidentalomas on chest CT scans, discuss the potential clinical significance of the findings, and suggest guidelines for reporting, further evaluation, and follow-up, with particular focus on thyroid lesions, enlarged mediastinal lymph nodes and lung nodules.

[1]  A. Aschoff,et al.  The cisterna chyli: prevalence, characteristics and predisposing factors , 2008, European Radiology.

[2]  R. Jeffrey,et al.  Incidental thyroid nodules on chest CT: Review of the literature and management suggestions. , 2010, AJR. American journal of roentgenology.

[3]  Y. Rho,et al.  The Prevalence and Significance of Incidental Thyroid Nodules Identified on Computed Tomography , 2008, Journal of computer assisted tomography.

[4]  G. Veronesi,et al.  The rate of incidental findings in lung cancer screening trials is not negligible , 2008, European Radiology.

[5]  Stephanie L. Lee,et al.  Revised American Thyroid Association management guidelines for patients with thyroid nodules and differentiated thyroid cancer. , 2009, Thyroid : official journal of the American Thyroid Association.

[6]  K. Ran,et al.  Prevalence of Significant Noncardiac Findings on Coronary Multidetector Computed Tomography Angiography in Asymptomatic Patients , 2007, Journal of computer assisted tomography.

[7]  G. Nakazawa,et al.  Noncardiac findings in cardiac imaging with multidetector computed tomography. , 2006, Journal of the American College of Cardiology.

[8]  J. Weissfeld,et al.  Non-Cardiac Findings on Coronary Electron Beam Computed Tomography Scanning , 2004, Journal of thoracic imaging.

[9]  P. Schnyder,et al.  CT of the thoracic duct. , 1983, European journal of radiology.

[10]  R. Jeffrey,et al.  Management of thyroid nodules detected at US: Society of Radiologists in Ultrasound consensus conference statement. , 2005, Ultrasound quarterly.

[11]  M. Oudkerk,et al.  Neglectable benefit of searching for incidental findings in the Dutch--Belgian lung cancer screening trial (NELSON) using low-dose multidetector CT , 2007, European Radiology.

[12]  N. Müller,et al.  Idiopathic interstitial pneumonias: prevalence of mediastinal lymph node enlargement in 206 patients. , 2006, AJR. American journal of roentgenology.

[13]  J. Remy,et al.  Mediastinal lymphadenopathy in congestive heart failure: a sequential CT evaluation with clinical and echocardiographic correlations , 2004, European Radiology.

[14]  F. Martinez,et al.  Thoracic Lymph Node Enlargement in Usual Interstitial Pneumonitis and Nonspecific-interstitial Pneumonitis: Prevalence, Correlation With Disease Activity and Temporal Evolution , 2006, Journal of thoracic imaging.

[15]  N. Müller,et al.  CT of chronic infiltrative lung disease: prevalence of mediastinal lymphadenopathy. , 1996, Journal of computer assisted tomography.

[16]  D. Naidich,et al.  Imaging of incidental findings on thoracic computed tomography. , 2011, Radiologic clinics of North America.

[17]  Ying Wang,et al.  Smooth or attached solid indeterminate nodules detected at baseline CT screening in the NELSON study: cancer risk during 1 year of follow-up. , 2009, Radiology.

[18]  Diederick E Grobbee,et al.  Prevalence of Incidental Findings in Computed Tomographic Screening of the Chest: A Systematic Review , 2008, Journal of computer assisted tomography.

[19]  Ronald L Eisenberg,et al.  Compliance with Fleischner Society guidelines for management of small lung nodules: a survey of 834 radiologists. , 2010, Radiology.

[20]  Jeffrey Mueller,et al.  Cardiac CT angiography after coronary bypass surgery: prevalence of incidental findings. , 2007, AJR. American journal of roentgenology.

[21]  S. Lam,et al.  Perifissural nodules seen at CT screening for lung cancer. , 2010, Radiology.

[22]  K. Horton,et al.  Prevalence of Significant Noncardiac Findings on Electron-Beam Computed Tomography Coronary Artery Calcium Screening Examinations , 2002, Circulation.

[23]  J. Austin,et al.  Guidelines for management of small pulmonary nodules detected on CT scans: a statement from the Fleischner Society. , 2005, Radiology.

[24]  R. Castellino,et al.  The cisterna chyli: a potential mimic of retrocrural lymphadenopathy on CT scans. , 1996, Radiology.

[25]  Michael M Maher,et al.  Significance of incidental thyroid lesions detected on CT: correlation among CT, sonography, and pathology. , 2006, AJR. American journal of roentgenology.

[26]  L. Green,et al.  Diagnostic and economic impact of heart failure induced mediastinal lymphadenopathy. , 2006, International journal of cardiology.

[27]  T. McLoud,et al.  Mediastinal lymphadenopathy and hazy mediastinal fat: new CT findings of congestive heart failure. , 1998, AJR. American journal of roentgenology.

[28]  Theodore R. Smith,et al.  The cisterna chyli: incidence and characteristics on CT. , 2002, Clinical imaging.

[29]  Guy T. Borders,et al.  Location, Size, and Distribution of Mediastinal Lymph Node Enlargement in Chronic Congestive Heart Failure , 2003, Journal of computer assisted tomography.

[30]  Myrna C B Godoy,et al.  Subsolid pulmonary nodules and the spectrum of peripheral adenocarcinomas of the lung: recommended interim guidelines for assessment and management. , 2009, Radiology.

[31]  D. Green.  Incidental findings computed tomography of the thorax. , 2005, Seminars in ultrasound, CT, and MR.

[32]  Kevin M. Johnson,et al.  Extracardiac findings on coronary CT angiograms: Limited versus complete image review. , 2010, AJR. American journal of roentgenology.

[33]  G. Bongartz,et al.  Coronary artery imaging with contrast-enhanced MDCT: extracardiac findings. , 2006, AJR. American journal of roentgenology.