Mediastinal Tuberculous Lymphadenitis Diagnosed by Endosonographic Fine Needle Aspiration

Abstract

Isolated mediastinal tuberculous lymphadenitis is clinically rare. Its clinical presentation may mimic an esophageal submucosal tumor by extrinsic compression. A 26-year-old woman was referred to our hospital for an esophageal subepithelial tumor. A 15×10 mm sized subepithelial lesion was found 30 cm from the upper incisors on esophagogastroduodenoscopy. We diagnosed the lesion as a submucosal tumor, and performed endoscopic ultrasonography-guided fine needle aspiration for a pathologic diagnosis. The histologic examination revealed granulomatous inflammation consistent with tuberculosis. We suggest that the use of endoscopic ultrasonography and fine needle aspiration may be helpful in making an early diagnosis and planning for an optimal treatment.

Isolated Tuberculous Mediastinal Lymphadenopathy in an Immunocompetent Child Without Pulmonary Involvement: A Case Report

“…Lymphadenitis is a significant extrapulmonary manifestation of tuberculosis [9]. Tuberculous lymphadenitis contributes about 4-7% of the total tuberculosis load, with mediastinal lymphadenopathy making up about 10% of all these cases [9]. It has a proclivity for young females and children, with 20-40 years as the peak age of onset [9].…”

“…Tuberculous lymphadenitis contributes about 4-7% of the total tuberculosis load, with mediastinal lymphadenopathy making up about 10% of all these cases [9]. It has a proclivity for young females and children, with 20-40 years as the peak age of onset [9]. The cervical lymph nodes are the most common sites for tuberculosis; however, the mediastinal, axillary, and inguinal lymph nodes are also found to be associated with the infection [10].…”

“…The mainstay of treatment is medical management with anti-tuberculous drugs [9]. Surgery is indicated only in extreme cases when the vital structures are compressed by the mass [9].…”

“…The mainstay of treatment is medical management with anti-tuberculous drugs [9]. Surgery is indicated only in extreme cases when the vital structures are compressed by the mass [9]. If not treated promptly, mediastinal lymphadenitis could end up with dysphagia due to extrinsic compression, vocal cord palsy resulting in recurrent laryngeal nerve palsy, or fistulation extending into the esophageal wall [9].…”