Thanks to Dr. Rowe for a great morning report case – a middle aged man with well-controlled HIV, ESRD on HD, referred to clinic for an abnormal CT as part of pre-transplant workup.
CT with some moderate subcarinal and right paratracheal lymphadenopathy, minimal parenchymal findings.
What next?
Differential:
- Sarcoidosis
- Infection (TB, endemic fungi, anything really)
- Malignancy
- Reactive
EBUS to the rescue! – REMEDY: AJRCCM 2012 study showed that EBUS mediastinoscopies in 87% of cases – 67/77 cases were diagnosed with EBUS; of the 10 undiagnosed, only 6 got diagnoses in mediastinoscopy
Thanks, Tim!
Timothy Rowe, MD, Pulmonary and Critical Care