OBJECTIVE: To evaluate the diagnostic yield of bronchoscopy and mediastinoscopy in adults with isolated mediastinal @entity1600 and to assess the effect of antituberculous treatment. DESIGN: Prospective longitudinal cohort study of 34 @entity1 with mediastinal @entity1600 followed for 6 to 19 months after completion of treatment. SETTING: Tertiary care hospital, Kuwait. @entity1 : 34 consecutive @entity1 who presented with isolated mediastinal @entity3329 from 1996 to 1998. INTERVENTIONS: Bronchoscopy and cervical mediastinoscopy for all @entity1 . MAIN OUTCOME MEASURES: Diagnostic yield of bronchoscopy and mediastinoscopy, and the outcome of treatment in @entity1 with @entity378 . RESULTS: The mean age was 35 years (range 15-58). The most common symptoms were cough, fever, and @entity353 . The chest radiographs and computed tomograms showed abnormal mediastinal shadows with no evidence of parenchymal disease. All @entity1 had right sided @entity3329 . Tuberculin skin test gave a weal of >15 mm in 17 @entity1 (50%). Sputum smears and cultures failed to grow acid-fast bacilli in any @entity1 . Seven @entity1 had an endobronchial abnormality and samples taken at bronchoscopy gave a definite diagnosis in 3 (9%). Paratracheal lymph node biopsy and culture by mediastinoscopy diagnosed @entity378 in all cases. All @entity1 were treated by a six month course of @entity1215 and @entity3109 supplemented initially by @entity5585 for two months. Twenty-eight @entity1 had a good response and the remaining @entity1 were treated for a further 3 months. CONCLUSIONS: Bronchoscopy has a low diagnostic yield in mediastinal @entity378 in the absence of a parenchymal lesion. Mediastinoscopy is a safe but invasive procedure and provides a tissue diagnosis in most cases. Six months treatment with @entity1215 and @entity3109 supplemented initially by @entity5585 is adequate treatment for most adults with @entity378 .

Diagnosis and treatment of isolated XXXX in adults.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient', 'PATIENTS'] @entity3329 :: ('MESH:D008206', 'Disease') :: ['paratracheal lymphadenopathy', 'lymphadenopathy'] @entity5585 :: ('MESH:D011718', 'Chemical') :: ['pyrazinamide'] @entity353 :: ('MESH:D015431', 'Disease') :: ['weight loss'] @entity1600 :: ('MESH:D014388', 'Disease') :: ['tuberculous lymphadenitis'] @entity3109 :: ('MESH:D007538', 'Chemical') :: ['isoniazid'] @entity1215 :: ('MESH:D012293', 'Chemical') :: ['rifampicin'] @entity378 :: ('MESH:D014376', 'Disease') :: ['tuberculous lymphadenopathy', 'tuberculous mediastinal lymphadenopathy', 'tuberculosis']
@entity378 :: (MESH:D014376,Disease) :: ['tuberculous mediastinal lymphadenopathy']
