Enlarged mediastinal lymph nodes in pulmonary tuberculosis suggest active anti-tuberculosis treatment. Enlarged mediastinal lymph nodes in patients with pulmonary tuberculosis suggests the possibility of mediastinal lymph node tuberculosis, through active anti-tuberculosis treatment, the mediastinal lymph nodes may slowly shrink, and with the prolongation of time some mediastinal lymph nodes may even be able to subside. In the course of treatment, lung CT should be repeated regularly to clarify the changes of mediastinal lymph nodes. In addition, if the mediastinal lymph nodes are enlarged in patients with tuberculosis, it is necessary to exclude the possibility of tumors. If the mediastinal lymph nodes do not subside after active anti-tuberculosis or anti-inflammatory treatments, it is recommended to consult a doctor, who can perform mediastinal lymph node puncture to further clarify the nature of the pathology, and then provide symptomatic treatment.