Tuberculous Lymphadenitis

Role of Mediastinoscopy in Intrathoracic Tuberculous Lymphadenitis

From 1993 to 1998, 19 patients with mediastinal tuberculosis underwent mediastinoscopy without any demonstrable parenchymal lesion and with negative diagnostic bronchoscopy. The mean age was 34.4 years (range, 15 to 67 years) and 10 were male. The most common symptom was cough in 12 patients, 4 were asymptomatic. Computed tomography showed involvement of the right paratracheal nodal station in 8 cases. Multiple biopsies of 3 to 5 mediastinal nodal stations diagnosed tuberculous lymphadenitis in 16 patients; in 5 of these, nonspecific inflammatory nodes were also sampled. In 3 patients who had biopsies of 1 mediastinal nodal station, the diagnosis could not be established. It was concluded that when used effectively, mediastinoscopy was acceptable as a final diagnostic step in patients with mediastinal tuberculous lymphadenitis.