Sahin F, Yildiz P
Pulmonologist, Department of Chest Diseases, Yedikule Chest Diseases and Thoracic Surgery Research and Training Hospital, İstanbul, Turkey.
Iran J Radiol. 2011 Sep;8(2):107-11. Epub 2011 Sep 25.
Mediastinal tuberculous lymphadenitis is a rare disease in adults. Dysphagia as the accompanying symptom is even a rarer manifestation. Cases with esophageal symptoms may present as esophageal ulceration, mucosal or submucosal mass, fistula or sinus formation, extrinsic compression or displacement of the esophagus. Extrinsic compression may radiologically or endoscopically present as a submucosal tumor. Our case is a 30-year-old woman with dysphagia for a month. Extrinsic compression was seen endoscopically on the mid-esophagus. On thoracic CT and MRI images, a multiloculated cystic/necrotic mass 5.5×4.8×3.1 cm in size consisting of multiple septa was located subcarinally in the middle mediastinum. In Wang needle aspiration, a mucopurulaent liquid was aspirated from the subcarinal localization by bronchoscopy. Diagnostic thoracotomy was carried out because histological and bacteriological examinations were not diagnostic. It was reported as tuberculous lymphadenitis pathologically. The control thoracic CT performed after antituberculous treatment showed complete regression of the mass. We herein report a rare form of tuberculous lymphadenitis.
纵隔结核性淋巴结炎在成人中是一种罕见疾病。吞咽困难作为伴随症状更是罕见表现。伴有食管症状的病例可能表现为食管溃疡、黏膜或黏膜下肿块、瘘管或窦道形成、食管外部压迫或移位。外部压迫在影像学或内镜检查中可能表现为黏膜下肿瘤。我们的病例是一名30岁女性,有一个月的吞咽困难症状。内镜检查发现食管中段有外部压迫。在胸部CT和MRI图像上,一个大小为5.5×4.8×3.1 cm的多房囊性/坏死性肿块,由多个分隔组成,位于中纵隔隆突下。在经王针穿刺抽吸时,通过支气管镜从隆突下部位抽出了黏液脓性液体。由于组织学和细菌学检查未能确诊,故进行了诊断性开胸手术。病理报告为结核性淋巴结炎。抗结核治疗后进行的胸部CT复查显示肿块完全消退。我们在此报告一种罕见的结核性淋巴结炎形式。