Mediastinal lymph node tuberculosis is divided into two types: primary and secondary. The primary cause is unknown and presents as a (chronic) lymphogranuloma. Secondary cases are most often spread by tuberculosis infection from adjacent sites, mostly from pulmonary tuberculosis. Primary cases are most often seen in immunocompromised individuals, especially those with AIDS, and are uncommon in healthy populations. Secondary mediastinal lymph node tuberculosis is more common in children and adolescents. Mediastinal lymph node tuberculosis is difficult to diagnose because there is no specific manifestation and no accurate and specific auxiliary examination. The diagnosis can be confirmed by the presence of circumferential enhancement of enlarged lymph nodes on CT scan of the chest, but most cases do not have this typical presentation. Mediastinal lymph node tuberculosis without acute concomitant symptoms (e.g. acute respiratory compression, superior vena cava syndrome, bronchial lymph Ling fistula) can be effectively controlled and cured by medical treatment. In a few cases, surgical treatment is required. Mediastinal lymph node removal [Indications] 1, compression or invasion of adjacent organs, and cause corresponding adverse reactions and symptoms, internal treatment for 3 months is ineffective or symptoms aggravated. 2.The patient cannot be distinguished from other mediastinal lymph node disorders and no clear diagnosis can be made. 3.The lesion lymph node diameter >3cm, and has formed a tuberculous abscess. Contraindications】 1.With other serious diseases that cannot tolerate surgery. 2. Those with clear diagnosis but without conservative medical treatment. Surgical method] Generally, the chest is opened from the side with heavy symptoms or signs, and all lesions are removed, and all visible lesions and enlarged lymph nodes and their surrounding fatty tissues are cleared. Precautions] 1. When clearing the enlarged lymph nodes, the surrounding fat should be removed together to reduce postoperative recurrence. 2.If there are purulent lymph nodes, avoid their breakage and contamination leading to tuberculous abscess chest. 3.After clearing the enlarged lymph nodes, adequate hemostasis should be performed to reduce the occurrence of internal bleeding. 4.Anti-tuberculosis treatment should be continued for at least 12 months after surgery.