🩺 Case Study: When Enlarged Chest Glands Reveal the Real 🌎📞 online consultation available 9910319688

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🩺 Case Study: When Enlarged Chest Glands Reveal the Real Diagnosis

A patient presented with enlarged mediastinal lymph nodes near the airway where the windpipe divides into right and left bronchi. To identify the exact cause, we performed Endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) — a minimally invasive procedure that allows ultrasound-guided sampling of chest lymph nodes.

During the procedure, multiple enlarged glands were visualized. To ensure diagnostic accuracy, 6 needle passes were taken from different areas, collecting 24–26 tissue samples.

Initial tests showed negative TB markers, while Angiotensin-converting enzyme (ACE) levels were elevated (115), suggesting a granulomatous inflammatory condition.

The biopsy report confirmed chronic granuloma. Importantly, there was no caseation necrosis, a feature commonly seen in Tuberculosis. Absence of necrosis favors Sarcoidosis, which presents with non-caseating granulomas.

✅ Final Diagnosis: Sarcoidosis
💊 Plan: Appropriate sarcoidosis management with regular follow-up and monitoring.

Key Message: Not every enlarged chest gland is TB or cancer. Accurate tissue diagnosis ensures the right treatment.

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