CTICasesBroncholymphatic Fistula in Tuberculosis Lymphadenitis
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Imaging findings
A patient with known tuberculosis lymphadenitis presents with necrotic supraclavicular, lower cervical, mediastinal, subcarinal, and paratracheal enlarged lymph nodes, which are low attenuation on CT. A follow-up CT, weeks later due to worsening cough, reveals new gas within the subcarinal lymph node and debris in the right lung.
Key takeaways
This case demonstrates a broncholymphatic fistula as a complication of tuberculosis lymphadenitis. The presence of gas within a necrotic lymph node, along with endobronchial spread of necrotic tissue and bacteria, explains the patient's cough and indicates communication between the lymph node and the bronchial tree.
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