PT  - JOURNAL ARTICLE
AU  - Kerry Woolnough
AU  - Maninder Kalkat
AU  - Heinke Kunst
TI  - Outcomes of cervical mediastinoscopy for undiagnosed lymphadenopathy: TB or not TB?
DP  - 2013 Sep 01
TA  - European Respiratory Journal
PG  - P2837
VI  - 42
IP  - Suppl 57
4099  - http://erj.ersjournals.com/content/42/Suppl_57/P2837.short
4100  - http://erj.ersjournals.com/content/42/Suppl_57/P2837.full
SO  - Eur Respir J2013 Sep 01; 42
AB  - IntroductionWe retrospectively reviewed the outcomes of patients with suspected tuberculous mediastinal lymphadenopathy undergoing cervical mediastinoscopy. We wanted to see what proportion of these patients had a diagnosis of tuberculosis confirmed/supported by tissue obtained from this procedure.MethodsHistological and microbiological data was retrospectively reviewed from patients undergoing a cervical mediastinoscopy with a suspected diagnosis of tuberculosis.Results88 patients with mediastinal lymphadenopathy, who had tuberculosis suspected as either their main or as part of the differential diagnosis, underwent cervical mediastinoscopy between January 2009 and January 2011. Tuberculosis was confirmed on the basis of acid fast bacillus seen on microscopy or from cultures in 16 patients. 2 of these patients had non-caseating granulomas on histology, 13 had caseating granulomas and 1 patient had non-diagnostic tissue obtained.Of the 88 patients with suspected tuberculosis 28 patients had non-caseating granulomas seen on histology, 31 patients had caseating granulomas, 4 had undifferentiated granulomas, 11 were seen to have malignant cells and 14 had normal, reactive, anthracotic, amyloid or non-diagnostic tissue identified on histology.ConclusionThese results highlight that when tuberculosis is part of the differential diagnosis of a patient with mediastinal lymphadenopathy 35.2% of these patients will have this diagnosis confirmed on histology and 18.2% will have this confirmed on the basis microscopy or culture from tissue obtained from cervical mediastinoscopy.