부산대학교 도서관

Background. Extrapulmonary tuberculosis can be complicated in dialysis patients. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been considered useful for the diagnosis of mediastinal tuberculous lymphadenitis. However, there are few reports on patients receiving peritoneal dialysis, not blood dialysis. Case. An 89-year-old woman developed a persistent fever of around 38°C at 4 months after the initiation of peritoneal dialysis for end-stage kidney disease. Chest contrast-enhanced computed tomography (CT) showed multiple mediastinal lymphadenopathies without pulmonary lesions. We performed EBUS-TBNA on the subcarinal lymph node (#7) and collected samples, including pus. The histopathological result was epithelioid cell-like clusters of histiocytes, and Mycobacterium tuberculosis was identified in the specimen. We made a diagnosis of mediastinal tuberculous lymphadenitis and started her on treatment with isoniazid (INH), rifampicin (RFP), and ethambutol (EB). Her symptoms and mediastinal lymphadenopathy gradually improved after the treatment. Conclusion. In patients on dialysis with lymphadenopathy, we should consider the possibility of tuberculous lymphadenitis in addition to malignancies. EBUS-TBNA is highly effective for diagnosing mediastinal tuberculous lymphadenitis.