Biopsy of lymph nodes at mediastinoscopy has been the method of diagnosis of tuberculosis in 14 patients; Mycobacterium tuberculosis was cultured from the nodes in nine cases, and in five there was histological evidence of the disease but cultural confirmation was lacking. All patients had radiographic abnormality of the superior mediastinum, and a frequent finding at mediastinoscopy was mediastinal fibrosis involving the fascia and lymph nodes. No cause other than tuberculosis could be demonstrated to account for the mediastinal fibrosis, and the patients made clinical recoveries in response to standard courses of antituberculosis chemotherapy. The development of superior vena caval compression was not observed.
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