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Abstract

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Article in Japanese

Case Report

A case of tuberculous supraclavicular lymphadenitis with right phrenic nerve paralysis

Yoshiyuki Itakuraa  Hirokazu Tokuyasua  Hirofumi Nakazakia  Yasuto Sakaguchib  Noritaka Isowab  Eiji Shimizuc 

aDivision of Respiratory Medicine andb Division of Thoracic Surgery, Matsue Red Cross Hospital
c Division of Medical Oncology and Molecular Respirology, Department of Multidisciplinary Internal Medicine, Faculty of Medicine, Tottori University

ABSTRACT

A 50-year-old woman was referred to our hospital because of right diaphragmatic elevation. Neck and chest CT revealed right supraclavicular and mediastinal lymphadenopathy. An acid-fast bacilli smear and a culture of sputum were negative, but an interferon-gamma release assay was positive. A histological examination of the biopsy specimen taken from the right supraclavicular lymph node showed the findings of epithelioid granulomas with Langhans giant cells; thus it was compatible with the tuberculous lymphadenitis. After antituberculosis standard therapy, the size of the lymph nodes was reduced, and the right diaphragm returned completely to its normal position on chest X-ray, suggesting that the phrenic nerve paralysis was caused by oppression resulting from the tuberculous supraclavicular lymphadenopathy.

KEYWORDS

Phrenic nerve paralysis  Tuberculous lymphadenitis 

Received 28 Jul 2011 / Accepted 24 Nov 2011

AJRS, 1(3): 237-241, 2012

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