Diagnostic challenges in mediastinal tuberculosis presenting as an anterior mediastinal mass

Background. Differential diagnosing of a mediastinal mass is a common challenge in clinical practice due to the many organs and vascular structures contained within mediastinum. One of the less common causes is tuberculosis, which may present as a mass-like lesion that mimics a mediastinal tumor. Case report. We report an unusual case of mediastinal tuberculosis in a 19-year-old male who presented with shortness of breath and right chest pain as chief complaints, followed by cough and fever. Chest X-ray and computed tomography (CT) scan revealed a lobulated anterior mediastinal mass, but histopathological examination confirmed the diagnosis of chronic granulomatous lymphadenitis consistent with tuberculosis. Conclusions. Diagnostic imaging plays a critical role in the evaluation of mediastinal masses, beginning with basic radiography and extending to advanced imaging such as CT scanning. Although CT can strongly suggest the diagnosis, tissue biopsy remains essential for definitive confirmation.