X Liu1, D Zhang, D Lin, J Zhao, L Wang. 1. Department of Thoracic Surgery, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021.
Abstract
OBJECTIVE: To find a effective method for diagnosing tuberculous lymphadenopathy and sarcoidosis of mediastinum. METHODS: Mediastinoscopy was conducted in patients who had enlarged mediastinal lymph nodes on chest CT or MRI and were clinically suspected of either tuberculosis or sarcoidosis. Biopsy was done to obtain pathological diagnosis, and make therapeutic program. RESULTS: Of this series of 25 patients, 16 cases were pathologically diagnosed as tuberculous lymphadenopathy, representing 64% (hyperplastic tuberculosis 14 cases; caseous tuberculosis 2 cases); 8 cases were sarcoidosis, representing 32%; one case was difficult to tell tuberculosis from sarcoidosis microscopically, representing 4%. Tuberculosis and sarcoidosis were causes of benign enlargement of mediastinal lymph nodes. They were hard to be differentiated from roentgnologically, sometimes even microscopically; and they might be confused with other malignant diseases, which can also cause the enlargement of mediastinal lymph nodes, such as lymphoma, metastatic malignancies, etc. Thus they were easily resulted in misdiagnosis. Of this series, the initial diagnosis of 21 cases were malignancies, representing 84%, two cases has even undergone chemotherapy at local hospitals. CONCLUSIONS: For patients with enlargement of mediastinal lymph nodes, mediastinoscopy is of great value. It was emphasized to make every effort to obtain definite pathological diagnosis before standard treatment.
OBJECTIVE: To find a effective method for diagnosing tuberculous lymphadenopathy and sarcoidosis of mediastinum. METHODS: Mediastinoscopy was conducted in patients who had enlarged mediastinal lymph nodes on chest CT or MRI and were clinically suspected of either tuberculosis or sarcoidosis. Biopsy was done to obtain pathological diagnosis, and make therapeutic program. RESULTS: Of this series of 25 patients, 16 cases were pathologically diagnosed as tuberculous lymphadenopathy, representing 64% (hyperplastic tuberculosis 14 cases; caseous tuberculosis 2 cases); 8 cases were sarcoidosis, representing 32%; one case was difficult to tell tuberculosis from sarcoidosis microscopically, representing 4%. Tuberculosis and sarcoidosis were causes of benign enlargement of mediastinal lymph nodes. They were hard to be differentiated from roentgnologically, sometimes even microscopically; and they might be confused with other malignant diseases, which can also cause the enlargement of mediastinal lymph nodes, such as lymphoma, metastatic malignancies, etc. Thus they were easily resulted in misdiagnosis. Of this series, the initial diagnosis of 21 cases were malignancies, representing 84%, two cases has even undergone chemotherapy at local hospitals. CONCLUSIONS: For patients with enlargement of mediastinal lymph nodes, mediastinoscopy is of great value. It was emphasized to make every effort to obtain definite pathological diagnosis before standard treatment.