Mediastinal T.B. Lymphadenopathy

This 27 year old UAE single female.

She presented with dry cough and low grade hectic fever for 2 months.

Radiological examinations showed:
    right hilar, right paratrachial anterior mediastinal lymphadenopathy matted with central necrosis suggestive of : T.B.
   Chest x-ray:  P-A view, Lateral view

CT scan chest:
        Image1, Image2, Image3, Image4

Rigid bronchoscopy showed  right main bronchus compressed from outside.

Bronchial mucosal biopsy and bronchial lavage were negative for acid fast bacilli. No malignant cells.

Bone marrow aspirate and trephine were within normal range.

Patient was put on anti T.B. medication and discharged home.
        The anti TB treatment:
            Pyrazinamide 2gm OD
            Rimactazide 300 mg 2 tab OD
            Neurobion 1 tab OD

After one and half month she was readmitted

Chest x-ray and CT scan were done and showed almost complete resolution of the previous lesion.
       
Chest x-ray
        P-A view, Lateral view

CT scan chest:
        Image1, Image2, Image3, Image4

She was discharged and  advised to continue the anti T.B. treatment.

END