Tuberculous mediastinal lymphadenopathy in an adult

Iyengar, Keerthi B; Kudru, Chandrashekar Udyavara; Nagiri, Shivashankara Kaniyoor; Rao, Anjali

doi:10.1136/bcr-2013-200718

Cited by 16 publications

(10 citation statements)

References 6 publications

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“…In Patients of our cohort, isolate mediastinal lymphadenopathy was detected in 46% of non-necrotizing granulomatous inflammation. ; this rate was 25% in patients diagnosed with tuberculosis (7,8). In our study, in both groups 1 and 2 the most common secondary pathologies were hilar LAP and parenchymal nodules (Figs.…”

Section: Discussionsupporting

confidence: 52%

“…The easiest and quickest method of diagnosis is ARB via the Ehrlich-Ziehl-Nielsen staining method. However, to show bacteria with direct microscopy, the material must contain at least 5000 to 10000 bacteria per mL [8]. In a study of newly diagnosed tuberculosis patients, it was reported that smear positivity could be shown in 50% to 80% of patients.…”

Section: Discussionmentioning

confidence: 99%

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The risk of tuberculosis bacilli seeding during mediastinoscopy in mediastinal tuberculosis: Is it clinically important?

BÜYÜKKARABACAK¹,

PİRZİRENLİ²,

Gürz³

et al. 2022

JECM

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Mediastinoscopy is the gold standard for diagnosis in the absence of parenchymal lesions in mediastinal tuberculosis lymphadenitis. During mediastinoscopy biopsy, tuberculous bacillus seeding into the mediastinum is a rare complication. This study aimed to test the safety of mediastinoscopy in terms of Mycobacterium tuberculosis seeding in the mediastinum by microbiologically evaluating mediastinal lavage samples taken before and after biopsy. Classical cervical mediastinoscopy was performed all of patients and who were reported as granulomatous inflammatory events results of histopathological examinations and who underwent mediastinal lavage before and after biopsy, were included in the study. All the lavage fluids were tested for AFB and subjected to Mycobacterium tuberculosis PCR DNA testing and standard tuberculosis culture. The patients were divided into two groups, Group 1: Necrotizing granulomatous inflammation, Group 2: non-necrotizing granulomatous inflammation. The microbiological tests of the patients in Group 1 were negative before biopsy. However, in two patients of Group 1, the results of cultures of lavage fluids that taken from after biopsy were positive for tuberculosis. In all patients in Group 2, all microbiological tests of the lavage fluids were negative (Power of the decision: 99.8%, with 5% error). All of patients in group 1, Antituberculosis treatment was initiated and continued for 6 months. There weren’t seen any serius complications due to treatment and recurrence during the follow-up period. Mediastinoscopy can be used safely, with low morbidity and mortality rates and a high success rate for the diagnosis of mediastinal tuberculosis.

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Section: Discussionsupporting

confidence: 52%

Section: Discussionmentioning

confidence: 99%

The risk of tuberculosis bacilli seeding during mediastinoscopy in mediastinal tuberculosis: Is it clinically important?

BÜYÜKKARABACAK¹,

PİRZİRENLİ²,

Gürz³

et al. 2022

JECM

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“…Isolated mediastinal lymphadenopathy is not unusual in children but rarely described in adults in the absence of associated parenchymal lesions. 1 Mediastinal lymph nodes can be enlarged in various pathological conditions like TB, sarcoidosis, lymphoma, and metastatic lung cancer. 2 A sampling of mediastinal lymph nodes is paramount for diagnosing these conditions and for staging patients with bronchogenic carcinomas.…”

Section: Discussionmentioning

confidence: 99%

Endobronchial Ultrasound in Evaluating Mediastinal Lymphadenopathy

Baikunje

Hosmane

Kumar

2021

Journal of Health and Allied Sciences NU

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Tuberculosis can involve most of the body parts, and tubercular lymphadenitis is common. But isolated involvement of mediastinal lymph nodes without lung parenchymal involvement is rare in adults. A 45-year-old lady presented with subcarinal lymph node enlargement. A conventional transbronchial needle aspiration done at a local hospital was inconclusive. Endobronchial ultrasound-guided transbronchial needle aspiration was done. Cytology showed epithelioid histiocytes and caseous necrosis. Stain for acid-fast bacilli and cartridge-based nucleic acid amplification test for tuberculosis were positive. Endobronchial ultrasound-guided transbronchial needle aspiration is a minimally invasive bronchoscopic technique to visualize and sample mediastinal lymph nodes. However, its availability is limited to specific centers and expertise is required to interpret images and take diagnostic samples.

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“…The incidence rates of tuberculous mediastinal lymphadenitis are 5% to 17.6% of total TB cases and decreased with the increasing of age. [ 14 , 15 ] Although, it is usually asymptomatic, the symptoms was reported that lymph nodes compresses upon adjacent structures. [ 4 ] The sensitivity of CT scanning on tuberculous lymphadenitis is 57% in total.…”

Section: Discussionmentioning

confidence: 99%

Combined transbronchoscopic needle aspiration (TBNA) and rapid on-site cytological evaluation (ROSE) for diagnosis of tuberculous mediastinal lymphadenitis

Dai

Ning²,

Yang³

et al. 2018

Medicine

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Introduction:The diagnosis of tuberculous mediastinal lymphadenitis remains a challenge, and the use of transbronchoscopic needle aspiration (TBNA) combined with rapid on-site cytological evaluation (ROSE) is still unclear. A case of tuberculous mediastinal lymphadenitis was illustrated to show the diagnostic value of TBNA and ROSE.Case presentation:In this case report, we presented a typical case of a 44-year-old male who underwent obvious odynophagia and mild symptom of dyspnea. One isolated mass positioned on posterior mediastinum was examined as positive discovery. Finally, he was diagnosed with tuberculous mediastinal lymphadenitis by using TBNA combined with ROSE and treated with anti-TB.Conclusions:TBNA is an efficacious and safe approach, which is worth popularizing for the clinical diagnosis of mediastinal masses. Meanwhile, ROSE is useful to reduce the numbers of needle passes during TBNA. We aimed to emphasize 2 key points in this case report. Firstly, a rare symptom of Tuberculosis in adults was supported by the patient. Secondly, TBNA combined with ROSE is useful for the diagnosis of tuberculous mediastinal lymphadenitis.

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Tuberculous mediastinal lymphadenopathy in an adult

Cited by 16 publications

References 6 publications

The risk of tuberculosis bacilli seeding during mediastinoscopy in mediastinal tuberculosis: Is it clinically important?

The risk of tuberculosis bacilli seeding during mediastinoscopy in mediastinal tuberculosis: Is it clinically important?

Endobronchial Ultrasound in Evaluating Mediastinal Lymphadenopathy

Combined transbronchoscopic needle aspiration (TBNA) and rapid on-site cytological evaluation (ROSE) for diagnosis of tuberculous mediastinal lymphadenitis

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