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.

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.