Clinical role of bronchoscopy in adults with intrathoracic tuberculous lymphadenopathy.

Twenty-five adult tuberculosis patients with intrathoracic lymphadenopathy were studied. Intrathoracic tuberculous lymphadenopathy seems rare in Chinese and affects more older and female subjects. The most common symptoms were cough, followed by chills, fever and the most common physical finding was peripheral lymph node enlargement. The roentgenographic appearance of mediastinal lesions varied but often included right paratracheal involvement. Nine patients had clear lungs. Tuberculous involvement was limited to the lower lung field in seven out of 16 patients with concomitant parenchymal lesions. The remaining nine patients had pulmonary tuberculosis involving the upper lobes. Consolidation was the most common form of pulmonary lesion. A diagnosis was made on the basis of sputum examination in nine patients; however, peripheral lymph node examination yielded a higher diagnostic rate (90 percent). Endobronchial involvement was proved by bronchoscopy in 12 of 16 patients. In three instances, the final diagnosis could be documented after mediastinoscopy or exploratory thoracotomy.