[Tuberculous mediastinal lymphadenitis presenting as hoarseness].

A 70 year-old woman was admitted to our hospital complaining of hoarseness. Bronchoscopic examination revealed that the left vocal cord was fixed in the paramedian position, and therefore left recurrent nerve paralysis was suspected. Although a chest X-ray film showed no abnormal findings, a chest computed tomogram showed that pretracheal (#3) and subaortic (#5) lymph nodes were swollen (1 to 2 cm in diameter). An open biopsy was done. Histological examination of the resected mediastinal lymph nodes revealed an accumulation of Langhans giant cells and epithelioid cells in caseous necrosis. An acid-fast bacillus was seen after Ziehl-Neelsen staining. This was a rare case of mediastinal tuberculous lymphadenitis in which hoarseness was useful for early diagnosis. Fifty-three cases of tuberculous mediastinal lymphadenitis have been reported in Japan.