Mediastinal lymph nodal TB complicated by amyloidosis and es
The present case has been reported in the International Journal of Mycobacteriology.

A 38-year-old male presented with 3 months of dysphagia, fever with night sweats, loose stools, and 12 kg weight loss. The patient was found to have mediastinal lymphadenopathy and endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) done had shown granulomatous inflammation consistent with tuberculosis.

Mantoux test was positive (20 mm × 15 mm). Patient had received antitubercular therapy for 6 months but now presented with a history of loose stools. Examination revealed bilateral pitting pedal edema. His hemogram and renal functions were normal. His liver function test was normal except for hypoalbuminemia (serum albumin: 1.1 g/dL). Urine examination revealed albuminuria and 24 h urinary protein was 2.9 g/day.

Endoscopy revealed a fistulous opening in the esophagus at 24 cm from incisors and reduced fold height with nodularity in duodenum. CT revealed a large subcarinal lymph node with air consistent with an esophago-nodal fistula. Histology showed amorphous eosinophilic amyloid deposition in submucosal duodenal blood vessels.

Case highlights:-
- The present case is reported for two uncommon events which complicated mediastinal lymph nodal tuberculosis:

First, the occurrence of amyloidosis after mediastinal lymph nodal tuberculosis and;

Second, occurrence of esophago-nodal fistula possibly as a complication of previous EUS.

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