Anthracotic mediastinal lymphadenopathy: case report

ABSTRACT

We report the case of a male patient, known to have rheumatic mitral valve disease, who presented to us with huge mediastinal lymphadenopathy and dry cough. He was a life-time non-smoker and the only past medical history was his exposure to smoke during the Gulf war in 1991. This patient was in Kuwait during the Iraqi invasion and had a continuous exposure to the polluted environment. Mediastinoscopic lymph node biopsy confirmed the diagnosis of anthracotic reactive lymphadenopathy and excluded other causes. Anthracotic pigmentation is a common finding in mediastinal lymph node biopsies especially in smokers, but symptomatic huge lymphadenopathy was rarely reported. This observation and its correlation to the gulf war are also not reported in the literature