There are many possible causes of multiple enlarged lymph nodes in the mediastinum, such as tuberculosis or lymph node tuberculosis, mediastinal lymph node metastasis from lung cancer, lymphoma, and lymphadenitis. Treatment includes anti-tuberculosis treatment, surgery, chemotherapy, radiotherapy, anti-infection treatment, etc. 1. Tuberculosis or lymph node tuberculosis: Tuberculosis requires long-term strict anti-tuberculosis treatment, and different combinations of drugs can be taken according to the condition, and the commonly used anti-tuberculosis drugs include isoniazid, rifampicin, pyrazinamide and so on. It is recommended to choose drugs under the guidance of professional doctors. 2. Mediastinal lymph node metastasis of lung cancer: mediastinal lymph node metastasis of lung cancer patients suggests that the disease has progressed, and radical surgery combined with lymph node dissection is preferred if the patients are eligible for surgery. If surgery is not suitable, patients can choose comprehensive treatment, including chemotherapy, radiotherapy, targeted therapy and immunotherapy. 3. Lymphoma: lymphoma is mainly treated with chemotherapy, and different combinations of chemotherapeutic drugs can be chosen according to different pathological types, commonly used drugs include doxorubicin, vincristine, cyclophosphamide, etc. CD20-positive patients can choose monoclonal antibody rituximab, which can improve the remission rate and prolong the survival of patients. 4. Lymphadenitis: mediastinal lymphadenitis is mostly caused by infections in neighboring areas, and the enlarged lymph nodes can subside on their own after anti-infective treatment for the primary infected foci. Commonly used drugs include cephalosporin, amoxicillin, levofloxacin and so on. When multiple enlarged lymph nodes are found in the mediastinum, it is recommended that the patient go to the hospital as soon as possible to get a clear picture of the nature of the lymph nodes, and consult with a professional doctor for appropriate treatment.