The Prevalence of Hilar Lymphadenopathy and Related Factors in Pneumoconiosis Patients of a University Hospital Occupational Diseases Polyclinic

Objective: Pneumoconiosis is a fatal, irreversible interstitial lung disease caused by various inorganic dust and chemicals. The disease is radiologically characterized by micronodules, pleural plaques, emphysema, mediastinal and hilar lymphadenopathies (HL). There are hypotheses that fibrotic lymph nodes increase the dust load of the lungs in patients with pneumoconiosis. Our aim is to determine the frequency of HL and related factors in pneumoconiosis patients admitted to our unit in the light of current data. Material and Methods: 76 patients diagnosed with pneumoconiosis who applied to our unit between November, 2015 and October, 2020 were retrospectively screened. Sociodemographic characteristics, radiological, laboratory and clinical findings were evaluated. The frequency of HL and related factors were analyzed. Results: We found the rate of HL as 29,3%. The average age was 43,78 ± 7,54. There was no significant age difference between patients with and without HL (44,41±8,90 / 43,34±6,93 p=0,578). All of the patients were male. As the ILO (International Labor Organization) category rose, we saw an increase in the number of HL. 59,1% of the patients with HL had at least one active complaint (dyspnea, cough or sputum). The most common complaint was dyspnea (50%). We found a statistically significant increase in NLR (Neutrophil to Lymphocyte Ratio) and TLR (Thrombocyte to Lymphocyte Ratio) values in patients with HL compared to those without (2,38±0,70; 1,97±0,59 p=0,016 and 133,79±39,06; 109,03±29,00 p=0,005). Another important finding was that the albumin values of patients with HL were found to be statistically significantly lower (4.42 ± 0.41; 4.67 ± 0.29 p = 0.008). Conclusion: 29.3% of patients had HL. We found significant increase in NLR and TLR in pneumoconiosis patients with HL and decrease in serum albumin levels. We think that these markers may have prognostic value in pneumoconiosis patients with lymphadenopathy.

PDF

___

[1] Remy-Jardin M, Degreef JM, Beuscart R, et al. Coal worker’s pneumoconiosis: CT assessment in exposed workers and correlation with radiographic findings. Radiology. 1990; 177(2): 363-71.

[2] Alıcı NŞ, Çimrin A, Beyan AC. Pneumoconiosis in different sectors and their differences in Turkey. Tuberk Toraks. 2016; 64(4): 275-282.

[3] Ergün D, Ergün R, Evcik E, et al. The relation between the extent of radiological findings and respiratory functions in pneumoconiosis cases of dental technicians who are working in Ankara. Tuberk Toraks. 2016; 64(2): 127-136.

[4] Gu HL, Fei WP, Hua PY, et al. Modified Glasgow Prognostic Score, and Neutrophil/lymphocyte and Platelet/ lymphocyte Ratios in Different Stages of Silicosis. Biomed Environ Sci. 2019; 32(5): 376-379.

[5] Karataş M, Gündüzöz M, Öziş TN, et al. Neutrophil to lymphocyte ratio and platelet to lymphocyte ratio as haematological indices of inflammatory response in ceramic workers’ silicosis. Clin Respir J. 2019; 13: 159–165.

[6] Chong S, Lee KS, Chung MJ, et al. Pneumoconiosis: Comparison of Imaging and Pathologic Findings. RadioGraphics. 2006; 26: 59 –77.

7] Nin CS, Souza VVS, Amaral RH, et al. Thoracic lymphadenopathy in benign diseases: A state of the art review. Respiratory Medicine. 2016; 112: 10-17.

[8] Cox-Ganser JM, Burchfiel CM, Fekedulegn D, et al. Silicosis in Lymph Nodes: The Canary in the Miner? Journal of Occupational and Environmental Medicine. 2009; 51(2): 164-169.

[9] Zhang R, Wu X, Hu W, et al. Neutrophil-to-lymphocyte ratio predicts hemorrhagic transformation in ischemic stroke: A meta‐analysis. Brain Behav. 2019; 9(9): e01382.

[10] Vincent JL, Russell JA, Jacob M, et al. Albumin administration in the acutely ill: what is new and where next? Crit Care. 2014; 18(4): 231.

[11] Vincent JL, Dubois MJ, Navickis RJ, et al. Hypoalbuminemia in acute illness: is there a rationale for intervention? A meta-analysis of cohort studies and controlled trials. Ann Surg. 2003; 237:319–334.

[12] Forget P, Khalifa C, Defour JP, et al. What is the normal value of the neutrophil-to-lymphocyte ratio? BMC Res Notes. 2017; 10(1): 12.

[13] Murray J, Webster I, Reid G, et al. The relation between fibrosis of hilar lymph glands and the development of parenchymal silicosis. Br J Ind Med. 1991; 48: 267-269.

[14] Kurtipek E, Bekci TT, Kesli R, et al. The role of neutrophillymphocyte ratio and platelet-lymphocyte ratio in exacerbation of chronic obstructive pulmonary disease. J Pak Med Assoc. 2015; 65: 1283‐1287.

[15] Karataş MB, İpek G, Onuk T, et al. Assessment of prognostic value of neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in patients with pulmonary embolism. Acta Cardiol Sin. 2016; 32: 313.

[16] DeLight N, Sachs H. Pneumoconiosis. Treasure Island (FL): StatPearls Publishing; 2021.

[17] Rivera-Ortega P, Molina-Molina M. Interstitial Lung Diseases in Developing Countries. Ann Glob Health. 2019; 85(1): 4.

[18] Satija B, Kumar S, Ojha UC and Gothi D. Spectrum of high-resolution computed tomography imaging in occupational lung disease. Indian J Radiol Imaging. 2013; 23(4): 287-296.

[19] Nin CS, Silveira de Souza VV, Amaral RH, et al. Thoracic lymphadenopathy in benign diseases: A state of the art review. Respiratory Medicine. 2016; 112: 10-17.