Intrathoracic Tuberculous Lymphadenopathy in Adults

THE INCIDENCE of pulmonary tuberculosis in the United States has decreased so dramatically over the last few decades¹ that the disease is frequently unrecognized on admission to general as well as to urban teaching hospitals.^2,3 The change in the clinical and roentgenographic spectrum of pulmonary tuberculosis in the adult has recently been emphasized by Khan et al.⁴ Mediastinal or hilar lymphadenopathy secondary to tuberculosis, though common in children with primary tuberculosis,^5,6 has been reported as an unusual mode of presentation of tuberculosis in the adult.^4,7,8 This type of nodal enlargement usually suggests the presence of a malignant process or sarcoidosis, and tuberculosis is often not considered in the differential diagnosis.^9,10

This study is a retrospective analysis of 33 cases of adult tuberculosis with intrathoracic lymphadenopathy detected during the last 20 years at this institution and at the Philadelphia General Hospital. The purpose of this