Tuberculous lymphadenopathy

Case contributed by Rodney Strahan
Diagnosis almost certain


Breathlessness, cough, night sweats and weight loss. Lives in a country with endemic tuberculosis.

Patient Data

Age: 12 years
Gender: Female

Bilateral pleural effusions, Left > Right, with mass effect on the mediastinum.

Narrowing of the right bronchus intermedius and left lower lobe bronchus, indicating hilar lymphadenopathy. There is also mediastinal lymphadenopathy with loss of the paratracheal stripe.

Case Discussion

Children's airways are smaller and more pliable than adults so they can be more easily compressed by enlarged hilar lymph nodes, especially from caseating tuberculosis. This makes airway compression or displacement on chest radiographs an important indirect feature of tuberculous lymphadenopathy in this age group.

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