Disseminated tuberculosis in a renal transplant recipient: presentation as an anterior mediastinal mass

A 26-year-old man who had had a successful cadaveric renal transplant six months previously was admitted for evaluation of fever and dysuria. Chest x-ray revealed a new left pleural effusion, bilateral nodular parenchymal densities, and an anterior mediastinal mass. A biopsy of the mediastinal mass to exclude concurrent malignancy and positive AFB stains from pleural fluid and urine confirmed a diagnosis of disseminated tuberculosis.