Involvement of Mediastinal Lymph Nodes Detected by HRCT Chest in Tuberculosis Positive Patients: A Cross-Sectional Study at a Tertiary Care Hospital, Sahiwal, Pakistan

Muhammad Waseem; Iqra Javed; Rabia Ejaz; Amaidah Mir; Huma Shafiq; Dr Mehwish Razzaq

doi:10.37185/

Authors

Muhammad Waseem Sahiwal Medical College, Sahiwal, Pakistan
Iqra Javed Sahiwal Medical College, Sahiwal, Pakistan
Rabia Ejaz CMH Kharian Medical College, Kharian, Pakistan
Amaidah Mir CMH Kharian Medical College, Kharian, Pakistan
Huma Shafiq CMH Kharian Medical College, Kharian, Pakistan
Dr Mehwish Razzaq CMH Quetta Institute of Medical Sciences (QIMS), Quetta, Pakistan

DOI:

https://doi.org/10.37185/

Keywords:

Diagnostic Imaging, Lymphadenopathy, Mediastinum, Mycobacterium Tuberculosis

Abstract

Objective: To determine the frequency, distribution, and clinical correlations of mediastinal lymph node involvement in confirmed pulmonary tuberculosis patients using High-Resolution Computed Tomography (HRCT).
Study Design: Cross-sectional study.
Place and Duration of Study: The study was conducted at the Department of Pulmonology, Sahiwal Teaching Hospital, Pakistan, from January 2024 to June 2025.
Methods: A total of 290 patients aged 18 years and above with sputum smear or GeneXpert-confirmed pulmonary tuberculosis were enrolled using a non-probability convenience sampling technique after obtaining informed consent. Patients with known malignancy, other granulomatous diseases, or those who refused consent were excluded. All participants underwent a detailed clinical evaluation, including assessment of demographic and clinical variables. HRCT of the chest was performed using a standardized imaging protocol for all patients. Mediastinal lymph node involvement was evaluated based on nodal size, anatomical location and radiological characteristics such as necrosis and calcification. Image interpretation was performed independently by two experienced radiologists to ensure accuracy and minimize observer bias.
Results: The most frequently involved groups were subcarinal (62.1%), right paratracheal (53.1%), and hilar (41.0%) nodes; prevascular and para-aortic nodes were involved in 24.1% and 17.6% of patients, respectively. Patients aged ≥50 years had significantly higher rates of lymph node involvement than younger patients (78.0% vs 62.0%, P = 0.01); similarly, smokers had higher rates of involvement than non-smokers (68.0% vs 52.0%, P = 0.03). Diabetes mellitus and hypertension were associated with greater lymphadenopathy (76.0% vs 61.0%, P = 0.02; and 81.0% vs 59.0%, P = 0.005, respectively).
Conclusion: Mediastinal lymph node involvement is highly prevalent among tuberculosis-positive patients in Pakistan, with subcarinal and paratracheal groups being the most affected. HRCT provides valuable diagnostic and prognostic information, and recognition of mediastinal lymph node patterns can enhance disease assessment and support clinical decision-making.

How to cite this: Waseem M, Javed I, Ejaz R, Mir A, Shafiq H, Razzaq M. Involvement of Mediastinal Lymph Nodes Detected by HRCT Chest
in Tuberculosis Positive Patients: A Cross-Sectional Study at a Tertiary Care Hospital, Sahiwal, Pakistan. Life and Science. 2026; 7(2): 161-
167. doi: http://doi.org/10.37185/LnS.1.1.1087