Tuberculosis Course for

English-speaking students

Chapter 3. Clinical forms of tuberculosis

3.3. Tuberculosis of intrathoracic lymphatic nodes

(tubercular bronchoadenitis)
 Bronchoadenitis
• Bronchoadenitis is a disease of the
lymph nodes of the lungs roots and the
mediastinum. In this form of primary
tuberculosis, intrathoracic lymph nodes
are mainly involved in the process of
inflammation.
 Clinical pattern of tuberculous
bronchoadenitis

• The course of tuberculous bronchoadenitis, as a rule, begins with

signs of acute intoxication and specific clinical symptoms:
- subfebrile temperature,
- deterioration of general condition;
- loss of appetite;
- weight loss;
- adynamia or excitation of nervous system.
Lymph node tuberculosis: caseous granuloma
and scarring

http://alf3.urz.unibas.ch/pathopic/e/getpic-fra.cfm?id=004010
 Lymph node tuberculosis.
Head and neck.

http://alf3.urz.unibas.ch/pathopic/e/getpic-fra.cfm?id=004007
 necrosis of lymph node with caseous necrosis.
Little lymphoid tissue is preserved.

http://alf3.urz.unibas.ch/pathopic/e/getpic-fra.cfm?id=008182 http://alf3.urz.unibas.ch/pathopic/e/getpic-fra.cfm?id=008180
lymph node tuberculosis: necrosis with acid
fast bacilli

http://alf3.urz.unibas.ch/pathopic/e/getpic-fra.cfm?id=008179
 Giant cell of the Pirogov-Langhans type with
intracytoplasmatic acid fast bacilli.

http://alf3.urz.unibas.ch/pathopic/e/getpic-fra.cfm?id=008174
TUBERCULOUS LYMPHADENITIS
http://granuloma.homestead.com/TB_GROSS_IMAGES.html
Lymph node caseating tuberculosis
• caseating tuberculosis
Lymphknoten ist mit
3.5cm Durchmesser
deutlich vergrössert. Auf
der Schnittfläche werden
unregelmässig begrenzte
weisse konfluierende
Herde sichtbar, die
verkäsenden Granulomen
entsprechen.

http://alf3.urz.unibas.ch/pathopic/e/getpic-fra.cfm?id=003208
TUBERCULOUS LYMPHADENITIS
http://granuloma.homestead.com/TB_GROSS_IMAGES.html
TUBERCULOUS LYMPHADENITIS
http://granuloma.homestead.com/TB_GROSS_IMAGES.html
TUBERCULOUS LYMPHADENITIS
http://granuloma.homestead.com/TB_GROSS_IMAGES.html
http://www.itg.be/itg/DistanceLearning/LectureNotesVandenEndenE/imagehtml/ppages/CD_1034_061c.htm

• Swollen cervical
lymph node due to
glandular
tuberculosis.
Tuberculosis of the cervical lymph nodes in a Vietnamese
boat refugee. Copyright ITM
http://www.itg.be/itg/DistanceLearning/LectureNotesVandenEndenE/imagehtml/ppages/CD_1004_010c.htm
Infiltrative bronchoadenitis. On chest x-ray the shadow of the right
lung root is extended the outside contour is dim, the structure is

blurred and intensity is increased.

 Left side tumorous lymphadenitis. Massive
enlargement of broncho-pulmonic lymphatic nodes.
(Chest x-ray and tomogram).
Calcified intratorasic nodes

• Figure 3-10. Minute

calcifications and
higher densities in the
lung roots
Tuberculous bronchoadenitis, phase of
calcification (tomography)
 Treatment of patients with
tubercular bronchoadenitis
• Must be complex, with assignment of antibacterial
drugs and vitamins on the background of sanitary-
hygienic regime.
• Early beginning of treatment of tubercular
bronchoadenitis in children and in adults and its
continuous realization during long term course
guarantees recovery of the patient and prevent the
complicated course of illness.
Intensive specific and pathogenetic treatment quickly
brings good results.