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《Clinical Medical Journal of China》 2004-04
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Mediastinal Tuberculous Lymphadenitis: A report of 23 Cases

Chen Chang Gao Wen Ding Jiaan (Department of Thoracic Surgery, Shanghai Pulmonology Hospital, Shanghai 200433)  
Objective: To investigate the clinical characteristics of mediastinal tuberculous lymphadenitis. Methods: Surgically proved 23 cases, treated between April 1986 and July 2002, were analyzed. Results: There were 10 males and 13 females in this group, aging 21~59 (average of 34.31) years old. No tuberculous toxic syndrome manifested. There were 3 cases of only left mediastinum, 12 of right side, and 8 cases were bilaterally involved. On chest CT, peripheral rim enhancement was seen in 9 cases. PPD tests were performed in 21 cases, and all were positive. Preoperatively, 16 cases (69.57%)were misdiagnosed as malignant diseases, 3 as benign tumors, a total of 4 were correct based on the pulmonary infiltration manifestation. 11 cases underwent exploratory thoracotomy, another 10 cases with mediastinoscopy. All of the patients were successfully treated with intensified anti-tuberculosis treatment (2HREZ/10-16HR). Conclusion:Lymph nodes involved in mediastinal tuberculous lymphadenitis are usually of multi-group, more frequently seen at right side. The density and morphological changes before and after intensification are crucial to CT diagnosis. PPD test and bronchoscopy are of value in certain cases. Surgery is both effective to make pathological diagnosis, and treat related complications. Postoperative anti-tuberculosis therapy should be emphasized.
【CateGory Index】: R522
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