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Hilar lymphadenopathy, a novel finding in the setting of coronavirus disease (COVID-19): a case report.
Mughal, Mohsin Sheraz; Rehman, Rameez; Osman, Ramy; Kan, Nathan; Mirza, Hasan; Eng, Margaret H.
  • Mughal MS; Monmouth Medical Center, An Affiliate of RWJ/Barnabas Health System, 300 2nd Avenue, Long Branch, NJ, 07740, USA. mohsinsherazmd@gmail.com.
  • Rehman R; Monmouth Medical Center, An Affiliate of RWJ/Barnabas Health System, 300 2nd Avenue, Long Branch, NJ, 07740, USA.
  • Osman R; Monmouth Medical Center, An Affiliate of RWJ/Barnabas Health System, 300 2nd Avenue, Long Branch, NJ, 07740, USA.
  • Kan N; Monmouth Medical Center, An Affiliate of RWJ/Barnabas Health System, 300 2nd Avenue, Long Branch, NJ, 07740, USA.
  • Mirza H; Beth Israel Deaconess Medical Center/Harvard Medical School, Boston, MA, USA.
  • Eng MH; Monmouth Medical Center, An Affiliate of RWJ/Barnabas Health System, 300 2nd Avenue, Long Branch, NJ, 07740, USA.
J Med Case Rep ; 14(1): 124, 2020 Aug 09.
Article in English | MEDLINE | ID: covidwho-706402
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.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Tomography, X-Ray Computed / Coronavirus Infections / Lymphadenopathy / Betacoronavirus Type of study: Case report / Prognostic study / Reviews Topics: Long Covid Limits: Aged / Female / Humans Language: English Journal: J Med Case Rep Year: 2020 Document Type: Article Affiliation country: S13256-020-02452-3

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pneumonia, Viral / Tomography, X-Ray Computed / Coronavirus Infections / Lymphadenopathy / Betacoronavirus Type of study: Case report / Prognostic study / Reviews Topics: Long Covid Limits: Aged / Female / Humans Language: English Journal: J Med Case Rep Year: 2020 Document Type: Article Affiliation country: S13256-020-02452-3