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Persistent Anemia Combined Increased Serum Sedimentation (ESR) for More Than Two Years Firstly Misdiagnosed as Lymphoma Ultimately Confirmed Systemic Lymph Nodes Tuberculosis by Endobronchial Ultrasound-guided Transbronchial Needle Aspiration Pathology: a Case Report and Literature Review by Yan L. Ge, Cong H. Liu, Meng H. Wang, Nan Wang, Zhen Z. Li, Xiao Y. Zhu, Hong L. Li, Zi Y. Cui, Hai F. Zhang, Xue Zhang, Hua L. Yu, Qian Zhang, Ai S. Fu

Background: Anemia combined with increased serum sedimentation (ESR) can be secondary to many diseases and may be ignored when the patient had few clinical symptoms. We report a case of persistent anemia combined with ESR for more than 2 years firstly misdiagnosed as lymphoma. When she received a chest CT scan multiple enlarged lymph nodes were found.
Methods: The chest contrast-enhanced CT scan and endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) in the right hilum enlarged lymph nodes were performed for diagnosis.
Results: The chest CT scan and EBUS showed multiple enlarged right hilum and mediastinum lymph nodes without calcification. Pathology of EBUS-TBNA showed multiple granulomas; Zeihl-Neelsen acid-fast stain was positive.
Conclusions: Systemic lymph node tuberculosis is rarely seen in adult patients. In a young patient who has anemia combined with increased ESR should be excluded if those changes are secondary to tuberculosis.

DOI: 10.7754/Clin.Lab.2018.180836