
Suggest Treatment For Mediastinal Lymph Nodes In The Precarinal Area

Lymph nodes are related to past T.B.
Detailed Answer:
Hello XXXXXXX
Thanks for writing to HCM
Few mediastinal lymph nodes seen in the pre carinal area are related to your past history of tuberculosis.
Tuberculosis of lung causes enlargement of these group of lymph nodes.Regression of size takes time.
Chest pain is not related to lymph nodes.
Chest pain may be due to other reasons like cardiovascular,musculoskeletal reasons etc.
You need proper clinical examination and investigation.
Investigations include routine hemogram,RBS,LFT,RFT,Lipid profile,Urine RE/ME,ECG in all lead,ECHO.Further investigations can be done if needed.
Proper treatment depend upon findings.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX


Just to update you about the earlier dignosis and need your suggestion based on the analysis.
Chest and back pain was started in Mar 2012.ATT was completed in Dec 2012.
I have done cardiac tests mutiple times with normal result.
Regarding the blood tests
CBC,ESR, Lipid Profile, FBS, BUN,CRP,TSH, Uric Acid,Vit B12 and Vit D has already been done with normal result except Vit D - 10.4 ng/ml
Additionally the CT scan, which was done in Aug 2013 shows the status normal for Mediastinum but Linear fibrotic strands noted in the posterior segment of left upper lobe. This was because of the PTB.
But the current CT scan reports shows
1. Few mediastinal lymph nodes seen in the pre carninal region.9(This is a new finding in the ccurrent Scan report)
2. Fibrosis in the left posterior upper zone
3. No features suggesting active focus in the lungs
My concern - Currently I am consulting with a Plumologist since six months.
The pain is floating between chest and back with uneaseness most of the time. Do I need to test for malingancy based on the current report and consult an Oncologist.
Please suggest. Thanks a lot for your previous reply.
Regards,
XXXXXX
ECG - 4 times, ECHO-2 times , TMT - Once
Please find detail answer below.
Detailed Answer:
Hello XXXXXX
Thanks for writing back
I don't think you have any malignant cause.
Your pulmonary findings are due to past T.B and it doesn't require any treatment.
Few enlarged lymph nodes are also not alarming.Few lymph nodes may get enlarged due to variety of reasons.
Chest pain and discomfort may be other reasons like heart burn,musculoskeletal reasons etc.
Upper GI endoscopy should be done because problem in upper GI causes same type of symptoms and it is important to rule out.
MRI D/L spine can be done after evaluation.
You should take vitamin D supplementation.
Proper treatment depend upon findings.
Get well soon.
Hope I have answered your question.
Further queries are most welcome.
Take Care
Dr.Indu XXXXXXX

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