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July 22, 1996

Isolated Mediastinal Tuberculous Lymphadenitis

Arch Intern Med. 1996;156(14):1582. doi:10.1001/archinte.1996.00440130132014

Intrathoracic tuberculous lymphadenitis, including that involving the mediastinum, is usually described as a complication of primary lung tuberculosis in children, but is an unusual presentation of tuberculosis in adult patients.1 Mediastinal tuberculous lymphadenitis (MTL) in the absence of parenchymal infiltrations is an even rarer presentation, especially in white patients.1,2 We recently cared for a white patient with tuberculosis who presented with MTL without lung involvement.

Report of a Case.  A 26-year-old white woman was admitted to the hospital because of a 2-month history of anorexia, weight loss (5 kg), tiredness, and low-degree fever. Her temperature was 37.7°C; respiratory rate, 20/ min; heart rate, 84/min; and blood pressure, 100/70 mm Hg. The findings of her physical examination were unremarkable. Laboratory tests revealed the following values: hemoglobin, 100 g/L; white blood cells, 8.1×109/L, with 0.62 neutrophils, 0.06 monocytes, and 0.32 lymphocytes; and erythrocyte sedimentation rate, 121 mm/h. Other