Mediastinal lymphadenopathy

[amitneetica]

I had my CT Scan and report is suggestive of mediastinal lymphadenopathy and report shows "multiple discrete oval/irregular soft tissue density masses which shows mild enhancemens following i.v. contrast administration seen in right para-tracheal, pre-carinal and pre-vertebral regions of the mediastinum. No nercrosis or rim enhancement is observed in the masses".
Further, I had ACE test (Angiotension Converting Enzyme) and my count was 111 which is more than the normal Ref. Range (8 - 65 )as mentioned in the report. Basis ACE test report my doctor told there is no sarcoidosis.
Now, my doctor is suggesting test for Endoscopy guided FNAC of LN.
Please help to diagnose the problem and suggest whether my case is going in right track.

[Corvin]

I was thinking, if you had a positive PPD test, then biopsy maybe wouldn't be necessary. Unless you have latent tuberculosis infection or have had a TB vaccine that made the test false positive and they aren't totally convinced that you have active TB right now and want to biopsy just to be sure.

I know this can be tough and confusing but I hope you feel better soon.

Take care

[amitneetica]

Hi Corvin,

Thanks for your kind reply.

Just to update that I have also chronic cough and fever since last 2 months and my doctors has started the treatment of Tuberculosis.

Warm Regards

[Corvin]

Hi amitneetica, Welcome to MedHelp! And thank you for the detailed question.

This is the right course for diagnosis, Sarcoidosis and Lymphoma can only be positively diagnosed or excluded by biopsy and micro analysis.

The only alternative way to biopsy the mediastinal lymph nodes is by Mediastinoscopy, which is a more invasive procedure.

ACE as you probably know is the only dependable test to monitor and diagnose Sarcoidosis, but is still not totally specific to Sarcoidosis.

I should mention when they were testing me they checked for Tuberculosis, and HIV, but I had no chronic cough that would indicate severe infection either.

I hope you have good news, and repost if you have more questions.

Take care