A case of a 27 year old female diagnosed as having TB and AIDS, who had a mediastinal lymph node fistulized to the esophagus, is presented. We correlate this description to 2 important aspects: 1) lymph node TB as the most frequent cause of extrapulmonary TB; 2) The association of TB and AIDS. We analysed the rareness of this association, suggesting the possible mechanism of production, commenting on the main clinical features and diagnostic/therapeutic attitudes of esophago-mediastinal fistula of TB origin.