Letter to the editorEndobronchial ultrasound-guided biopsy in the evaluation of intrathoracic lymphadenopathy in suspected tuberculosis: A minimally invasive technique with a high diagnostic yield
Section snippets
Case 1
A 45 year-old HIV-infected male was referred to our service with mediastinal intrathoracic lymphadenopathy on chest radiograph. He gave no history of overseas travel, reported no respiratory symptoms and was constitutionally well. He had started anti-retroviral treatment three months prior and his absolute CD4 count was 4 × 106/L. CT chest revealed right-sided upper and lower paratracheal lymphadenopathy. Routine bronchoscopy was unremarkable and bronchoalveolar lavage washings were culture
Case 2
A 15 year-old girl was referred to our institution with mediastinal intrathoracic lymphadenopathy on chest radiograph. Health screening by her local practitioner identified her as HIV positive. Her absolute CD4 count was 598 × 106/L. A tuberculin skin test showed greater than 30 mm induration after 48 h with associated central ulceration. Chest CT revealed right-sided paratracheal lymphadenopathy (Fig. 1a). EBUS-TBNA sampling was performed under general anaesthesia with a laryngeal mask airway (
Conflict of interest
None declared.
References (8)
- et al.
Diagnosis of mediastinal adenopathy-real-time endobronchial ultrasound guided needle aspiration versus mediastinoscopy
J Thorac Oncol
(2008) - et al.
Mediastinoscopy in the diagnosis of mediastinal disease. An analysis of 181 explorations
Arch Bronconeumol
(2003) - et al.
Underutilization of transbronchial needle aspiration: experiences of current pulmonary fellows
Chest
(1997) - et al.
Pulmonary tuberculosis: comparison of CT findings in HIV-seropositive and HIV-seronegative patients
Radiology
(1996)
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