MEDIASTINOSCOPY IN AIDS

Lymph nodes involvement in AIDS is quite frequent and related to HN et iopathogeny, besides it may be a complication of opportunistic infecti ons and tumoral causes. Usually there is no difficulty in performing p eripheral biopsies under local anesthesia because of sistemic widespre ad distribution of adenomegalia. Some cases, however, may need more ag gressive proceedings due to local deep adenopathy, e.g. in mediastinum . Since 1993 mediastinoscopy was performed in 11 patients, all of them them presenting mediastinal evidence of enlarged lymph nodes at CT. M ain clinical manifestations were fever and prostration. There were no complications related to the procedure. Microbiologic and histologic e xaminations revealed tuberculosis (4 cases), atypical mycobacteriosis (2 patients), funghi (2) and lymphoma (3 cases). In 8 patients other o perative procedures with diagnostic aim were simultaneously performed (concerning lung and/or liver diseases). Differences in etiology betwe en the involved organs in a same patient were found in 6 cases. We con clude that the mediastinum must be considered as a possible site of lo cal adenopathy in AIDS patients, deserving surgical exploration if nec essary. Mediastinoscopy has low morbidity and high diagnostic yield al lowing an efficient and precise treatment.