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

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.