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Does a patient with mediastinal lymphadenitis with a highly postive mantoux with no other group of lymph node involvement with a lesion in the lung need a lymph node biopsy to diagnose tuberculosis?

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Does a patient with mediastinal lymphadenitis with a highly postive mantoux with no other group of lymph node involvement with a lesion in the lung need a lymph node biopsy to diagnose tuberculosis?

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The whole clinical picture has to be taken into account.CT scan and bronchoscopy might be advisable before undertaking biopsy.Since mantoux is highly positive sarcoidocsis seems less probable(HIV coexisting with TB also seems ruled out) and absence of other lymph node involvement seems to rule ou lymphomas.

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