Tuberculous mediastinal lymphadenopathy presenting with left vocal cord palsy: A rare entity

Vinatha, Kodam; Kumar, Dasari Pradeep; Ramesh, Vardhelly; Prasad, Chitta Ranjan; Madire, Ramulu; Kilaru, Hemanth; Sudeep, Madisetty Venkat; Maturu, Venkata Nagarjuna; Kilaru, Satish Chandra

doi:10.1016/j.ijtb.2019.11.013

Cited by 2 publications

(3 citation statements)

References 10 publications

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“…The proposed mechanisms for RLN palsy in mediastinal TB are compression by adjacent inflamed lymph nodes (the likely mechanism in our case), direct spread of infection from a perforated node that damages the RLN, and a T-cell mediated immune damage involving the RLN due to its proximity to a necrotic lymph node [ 11 , 12 ]. Only a handful of case reports have described isolated unilateral vocal cord palsy as the sole manifestation of enlarged mediastinal lymph nodes due to TB [ 6 , 7 , 11 - 13 ]. However, unlike the previous case reports, constitutional symptoms such as persistent low-grade fever, fatigue, rapid weight loss, and loss of appetite were not noted in our case.…”

Section: Discussionmentioning

confidence: 99%

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Tubercular Mediastinal Lymphadenopathy Presenting as an Isolated Unilateral Vocal Cord Palsy and the “Sail” Sign

Saluja,

Anees,

Abbey

et al. 2024

Cureus

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Tuberculosis continues to remain a major public health challenge, especially in low- and middle-income countries. Unilateral vocal cord palsy in adults as the sole manifestation of tubercular mediastinal lymphadenopathy has been rarely reported. A 22-year-old lady presented with a history of hoarseness of voice for the past month. The general physical examination revealed palpable lymph nodes in the left axilla. Axial CT sections at the level of the vocal cords demonstrated dilation of the right laryngeal ventricle and mild anteromedial deviation of the ipsilateral arytenoid cartilage (“sail” sign) suggestive of a right vocal cord palsy. Contrast-enhanced CT chest revealed right paratracheal, right hilar, and subcarinal lymph nodes with areas of central necrosis. She was started on anti-tubercular therapy and her voice completely improved after three months of treatment. The “Sail” sign on axial CT scans is a useful radiological sign for diagnosing unilateral vocal cord palsy. Rarely, compression of the recurrent laryngeal nerve by enlarged mediastinal lymph nodes due to tuberculosis can present with unilateral vocal cord palsy as the sole manifestation in adults.

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Section: Discussionmentioning

confidence: 99%

“…Mediastinal lymphadenopathy due to TB without lung parenchymal involvement commonly occurs in children and is rare in adults [ 5 ]. Furthermore, unilateral vocal cord palsy in adults as the sole manifestation of tubercular mediastinal lymphadenopathy has been rarely reported [ 6 , 7 ].…”

Section: Introductionmentioning

confidence: 99%

Tubercular Mediastinal Lymphadenopathy Presenting as an Isolated Unilateral Vocal Cord Palsy and the “Sail” Sign

Saluja,

Anees,

Abbey

et al. 2024

Cureus

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“…The larger the LN, the less the contrast loss. 21 3. A maximum short axis diameter greater than 8mm is the most commonly used CT criterion for the diagnosis of specific metastatic LNs.…”

Section: Methodsmentioning

confidence: 99%

A Pilot Study of Prognostic Value of Metastatic Lymph Node Count and Size in Patients with Different Stages of Gastric Carcinoma

Gao¹,

Wang²,

Tang³

et al. 2022

CMAR

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Background The correlation between the preoperative lymph node count (LNC) on multidetector computed tomography (MDCT) and the prognosis of gastric carcinoma (GC) remains to be defined. This research aims to evaluate the prognostic value of LNC on MDCT in GC patients based on tumor-node-metastasis (TNM) staging, using different size criteria for counting. Methods The clinical data of 126 patients with gastric adenocarcinoma undergoing gastrectomy were retrospectively analyzed. Lymph nodes greater than 8mm and 5mm on MDCT were counted and recorded. The prognostic implications of LNC on MDCT for patient survival were analyzed according to different size criteria for counting and tumor TNM staging. Results When 8mm was used as the counting criterion, LNC on MDCT had no significant effect on the overall survival (OS) of the entire cohort. In addition, the OS of T1–T2 GC patients with LNC on MDCT ≥1 was significantly worse than that of patients with LNC on MDCT <1. When 5mm was used as the counting criterion, LNC on MDCT was found to be significantly associated with the OS of the entire cohort. In the subgroup analysis, patients with relatively advanced (T3-T4, N+ and III) GC with LNC on MDCT >7 showed a significantly worse OS than those with LNC on MDCT ≤7. LNC on MDCT >7 with 5mm as the counting criterion and Stage III were independent risk factors for adverse prognosis. Conclusion The prognostic value of LNC on MDCT based on different size criteria varies in patients with different stages of GC. LNC of a smaller size (5mm) on MDCT may be a prognostic factor for patients with relatively advanced GC.

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Tuberculous mediastinal lymphadenopathy presenting with left vocal cord palsy: A rare entity

Cited by 2 publications

References 10 publications

Tubercular Mediastinal Lymphadenopathy Presenting as an Isolated Unilateral Vocal Cord Palsy and the “Sail” Sign

Tubercular Mediastinal Lymphadenopathy Presenting as an Isolated Unilateral Vocal Cord Palsy and the “Sail” Sign

A Pilot Study of Prognostic Value of Metastatic Lymph Node Count and Size in Patients with Different Stages of Gastric Carcinoma

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