SIX CASES OF HILAR LYMPH NODES TUBERCULOSIS OBSERVED AMONG ADULTS

Abstract

Six cases of hilar lymph nodes tuberculosis presumed to be primary tuberculosis were observed among adults of 21 to 48 years of age.
Their tuberculin reaction had b e en negative, sometimes weakly positive after BCG vaccination, and none of them had shown strongly positive reaction previously. At the time of onset, 4 cases had high fever up to 39°C which subsided spontaneously before chemotherapy or shortly after its initiation. Tubercle bacilli were cultured in 5 cases (3 in sputum, 2 in biopsied scalene lymph nodes, 1 in gastric juice), and caseous lesions were recognized in all of the 3 biopsied scalene lymph nodes. This fact suggests that the scalene lymph node biopsy is an usefull tool for the diagnosis of hilar lymph node tuberculosis, and that the bacteriological examination of the biopsied nodes is nessesary to ascertain the drug sensitivity of the bacilli as well as to differentiate the disease from sarcoidosis.
Hilar lym p h nodes tuberculosis have been believed to be a disease of children or adolescent, however, it is now not rare in adults as well as in the younger age as the results of the recent reduction in the prevalence tuberculosis in this country and of the consequent shift of the age of primary infection to the higher age groups.