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Year : 2015  |  Volume : 4  |  Issue : 3  |  Page : 225-228

Starry sky sign: A prevalent sonographic finding in mediastinal tuberculous lymph nodes

1 Chest Physician, Lung Transplantation Center, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara, Turkey
2 Chest Physician, Department of Pulmonology, Gazi University, Ankara, Turkey
3 Associate Professor for Pulmonology, Department of Pulmonology, Atatürk Chest Diseases and Thoracic Surgery Education and Research Hospital, Ankara, Turkey
4 Doctor of Philosophy, Department of Biostatistics, Hacettepe University, Ankara, Turkey

Correspondence Address:
Dr. Ibrahim Onur Alici
Chest Physician, Lung Transplantation Center, Turkiye Yuksek Ihtisas Training and Research Hospital, Ankara
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2303-9027.163004

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Background and Objectives: We report a prevalent finding in tuberculous lymphadenitis (TL): Starry sky sign, hyperechoic foci without acoustic shadows over a hypoechoic background. Materials and Methods: We retrospectively searched the database for a possible relationship of starry sky sign with a specific diagnosis and also the prevalence and accuracy of the finding. Results: Starry sky sign was found in 16 of 31 tuberculous lymph nodes, while none of other lymph nodes (1,015 lymph nodes) exhibited this finding; giving a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of 51.6%, 100%, 100%, 98.5%, and 98.5%, respectively. Conclusion: Bacteriologic and histologic findings are gold standard in the diagnosis of tuberculosis, but this finding may guide the bronchoscopist in choosing the more pathologic node within a station and increase the diagnostic yield as it may relate to actively dividing mycobacteria.

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