Kawasaki T, Gotoh T, Nakamura T, Hashimoto S, Arimoto T, Iwasaki Y, Ono M, Toda S, Dobashi Y, Nakagawa M
Department of Respiratory Diseases, Kyoto Prefectural Rakuto Hospital.
Nihon Kyobu Shikkan Gakkai Zasshi. 1996 Nov;34(11):1244-8.
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.
一名70岁女性因声音嘶哑入院。支气管镜检查发现左侧声带固定于旁正中位，因此怀疑左侧喉返神经麻痹。虽然胸部X光片未发现异常，但胸部计算机断层扫描显示气管前（#3）和主动脉下（#5）淋巴结肿大（直径1至2厘米）。进行了开放性活检。对切除的纵隔淋巴结进行组织学检查，结果显示在干酪样坏死中有朗汉斯巨细胞和上皮样细胞聚集。萋-尼染色后可见抗酸杆菌。这是一例罕见的纵隔结核性淋巴结炎，其中声音嘶哑有助于早期诊断。日本已报道53例结核性纵隔淋巴结炎病例。
