부산대학교 도서관

Background. Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) has been considered useful for the diagnosis of tuberculous lymphadenopathy. Case. A 76-year-old man had fever and general malaise at the time of introduction of hemodialysis. Chest CT images showed mediastinal lymphadenopathies. We performed EBUS-TBNA twice targetting mainly nonnecrotizing area of mediastinal lymph node, but could not confirm a diagnosis pathologically or bacteriologically. Subsequently, mediastinal lymph nodes resected by mediastinoscopy revealed necrotizing granulomas with Langhans giant cell, and a positive culture for Mycobacterium tuberculosis. We diagnosed of tuberculous lymphadenopathy. Conclusion. Generally, EBUS-TBNA has been considered to be useful for the diagnosis of tuberculous lymphadenopathy, but occasionally it is difficult to diagnose it even by EBUS-TBNA.