Thoracic Lymph Node Enlargement, a Symptom Associated With Asbestos Exposure


CT scans are the primary noninvasive tests for evaluating thoracic lymph nodes. The patterns showing enlarged lymph nodes on CT scans can provide important clues in the diagnosis of many thoracic diseases, including those stemming from asbestos exposure.

Thoracic lymph nodes reside in the chest wall, the chest cavity (mediastinum), and the lungs, and their imagistic review is essential in revealing the development of various pulmonary and extrapulmonary diseases. The chest cavity or mediastinum describes several structures, including:

  • trachea
  • esophagus
  • heart
  • large blood vessels

Enlarged mediastinal lymph nodes (MLNs) are often signs of severe irregularities in the body, so a CT image is of importance in differential diagnoses as well. MLNs can swell for several reasons, including:

  • asbestosis
  • silicosis
  • cancer
  • lower respiratory tract infection
  • inflammatory condition
  • autoimmune disease

High-resolution CT findings have shown that enlargement of lymph nodes in the chest cavity - mediastinal lymphadenopathy - frequently occurred in individuals with asbestos-induced pulmonary fibrosis and benign asbestos-induced pleural disease. The same imagistic test revealed that MLN enlargement is typical in asbestosis and gave doctors a pointer in investigating malignant diseases in patients with asbestosis.

Even though, in most cases, enlarged lymph nodes may be simply reactive to various pathogens like bacteria or viruses, threading carefully is the key when analyzing CT scans of individuals with known asbestos exposure background. Misinterpretations could exclude severe diseases like lung carcinoma, which typically manifests in MLN enlargements. Science regards asbestos exposure today as one of the causes that predispose patients to develop cancerous tumors, and enlarged MLNs on CT scans would usually be interpreted as evidence of metastatic spread in a developing malignancy. Moreover, a study focusing on CT findings of patients with pulmonary fibrosis shows a prevalence of enlarged intrathoracic lymph nodes in asbestos-exposed individuals.

Veterans' Thoracic Lymph Node Enlargement and Asbestos Exposure

Intrathoracic lymph nodes have recently been identified as critical targets in interstitial lung diseases, especially in environmental toxic exposure cases, such as asbestos exposure of naval personnel. Medical specialists have noted enlarged lymph nodes on chest cavity CT of individuals exposed to asbestos and in those exposed to respirable crystalline silica. They concluded that swollen MLNs are potential signs of early-stage asbestosis and silicosis.

In the context of well-defined occupational toxic exposures, nodules in MLNs are markers of an elevated lung cancer risk. Furthermore, an environmental health pilot study on inhaled particulate matter passage, such as asbestos dust, to various organs concluded that asbestos fibers are found more often in the thoracic lymph nodes than the lung tissues after occupational or non-occupational exposure. However, thoracic lymph node enlargement related to asbestos exposure is accompanied most times by symptoms such as:

  • problematic swallowing
  • coughing
  • fever
  • night sweats
  • general weakness
  • shortness of breath
  • wheezing

Swelling in the intrathoracic lymph nodes or mediastinal lymphadenopathy can occur due to malignant or benign causes. Enlarged MLNs are not a disease but a manifestation of another underlying condition, so it is crucial to establish the correct reason for this type of lymphadenopathy. Usually, lymph nodes swell or enlarge while they filter out the "bad" cells, when the immune system fights infection, or when they try to ward off invading cancerous cells. Malignant causes of swollen thoracic lymph nodes are usually cancers, including:

  • lung cancer
  • lymphoma

It is also possible for enlarged intrathoracic lymph nodes to occur as a result of metastatic spread of other cancers, such as:

  • esophageal cancer
  • prostate cancer
  • gastrointestinal cancer

Among non-cancerous causes of enlarged thoracic lymph nodes is COPD, one of the most common causes of mediastinal lymphadenopathy in the United States. Other benign causes include:

  • sarcoidosis
  • tuberculosis
  • cystic fibrosis
  • certain autoimmune diseases

Periodic Medical Examinations Are Crucial to Diagnose Asbestos Diseases Early

Asbestos diseases are complex due to the multifaceted immune responses they trigger and manifest symptoms similar to other less severe respiratory disorders. It makes their diagnosis challenging, and doctors may misinterpret the signs and conclude an inexact diagnosis, advising inadequate treatments and consuming precious time when time is of the essence. Reaching an accurate diagnosis on time is vital when dealing with asbestos illnesses, as they further erode veterans' health while being mistreated.

Veterans can expedite the diagnostic process by requesting a second or a third doctor's opinion outside the VA for a thorough evaluation of their condition and to ensure receiving a correct conclusion. Being open about the service in the Navy and the chances of asbestos exposure on ships built before the 1980s can give the doctor a needed perspective for an accurate assessment. It could facilitate the discovery of non-cancerous asbestos diseases such as:

Although benign asbestos illnesses don't qualify veterans for compensation, they should be regularly checked, as they tend to develop into cancer. Malignant transformations can be detected with periodic chest X-rays, CT scans, and pulmonary function tests, and a cancer diagnosis will make veterans eligible to file claims. Being diagnosed with cancer disturbs life's normal flow for everyone and can alter the sense of time. Even so, veterans faced with asbestos-related cancer should not forget that eligibility has a statute of limitations of up to five years from the date of diagnosis. Family members of deceased veterans can file a claim for three years from the date of the loved one's passing.

We Offer Help for Veterans in Filing Claims for Compensation

Former service members injured by asbestos fibers while fulfilling duty in the Navy between World War II and the 1980s have the right to seek compensation from asbestos trust funds and the VA to cover the overwhelming costs that come with medical treatment and hospitalization if they have proof of asbestos exposure and were diagnosed with the following asbestos-related cancers:

If your medical documents show any of the malignancies listed above and you choose to make legal steps, an asbestos lawyer can help you gather the necessary documentation and then represent you through the process, ensuring the success of your case. We can help by putting you in touch with legal experts who are ready to take on your case.

If you have a cancer diagnosis please contact us

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