Diagnosis of Mediastinal Mycobacterial Lymphadenopathy by Transbronchial Needle Aspiration (1)

Diagnosis of Mediastinal Mycobacterial Lymphadenopathy by Transbronchial Needle Aspiration (1)Fine-gauge flexible transbronchial needle aspiration (TBNA) is a useful technique for diagnosing mediastinal spread of cancer, but it has had a limited role in the diagnosis of benign disease in the mediastinum. This report describes a patient with the acquired immunodeficiency syndrome (AIDS) diagnosed with Mycobacterium avium-intracellularv (MAI) complex infection by TBNA of subca-rinal lymph nodes, and thus illustrates the potential role of TBNA in diagnosing intrathoracic mycobacterial lymphadenopathy.
Case Report
A 35-year-old man without significant medical history presented to the emergency department in February 1990 complaining of fever, dyspnea, and a dry cough. The patients chest roentgenogram revealed bilateral increased interstitial infiltrates; he tested human immunodeficiency virus (HIV) positive, and a bronchoalveolar lavage was diagnostic of Pneumocystis carinii pneumonia. The patient recovered uneventfully following a three-week course of intravenous trimethoprim-sulfamethoxazole, and was maintained as an outpatient on a regimen of zidovudine (AZT) and aerosolized pentamidine. Five months following hospital discharge, the patient returned complaining of temperature to 39.4°C, night sweats, weight loss, generalized malaise, anorexia, mild right upper quadrant abdominal pain, and watery diarrhea that had been present for the past month.

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