scholarly journals Left Lateral Cervical Mass with Draining Sinuses

2019 ◽  
Vol 2019 ◽  
pp. 1-6 ◽  
Author(s):  
Stylianos A. Michaelides ◽  
George D. Bablekos ◽  
Avgerinos-Romanos Michailidis ◽  
Efthalia Gkioxari ◽  
Stephanie Vgenopoulou ◽  
...  
Keyword(s):  
Clinical Symptoms ◽  
Extrapulmonary Tuberculosis ◽  
Cervical Lymphadenopathy ◽  
Complete Recovery ◽  
Tuberculous Lymphadenitis ◽  
Male Smoker ◽  
Oral Steroids ◽  
Cervical Swelling ◽  
Uncommon Case ◽  
Physical Findings

The aim of the present study is to describe an uncommon case of tuberculous lymphadenitis (TL) in a symptomless 89-year-old male smoker patient, who presented at the emergency department of our hospital with left lateral cervical swelling with draining sinuses. No other clinical symptoms or physical findings were observed at admission. An elevated erythrocyte sedimentation rate (ESR) and a small calcified nodule in chest CT were the only abnormal findings. Pus samples from sinuses were examined and confirmed tuberculosis which was in agreement with surgical pathology of lymph nodes. A four- (4-) drug antituberculous regimen was administered. After an initial remission of his symptoms, the patient presented an exacerbation of the cervical swelling with draining sinuses necessitating addition of oral steroids. TL can be symptomless presenting a paradoxical reaction during treatment. The uniqueness of our case lies in the patient’s advanced age, which is uncommon with cervical lymphadenopathy as a form of extrapulmonary tuberculosis, as well as in the administration of oral steroids to resolve the neck’s clinical deterioration. The patient had a complete recovery and was free of disease after completion of his six-month antituberculous chemotherapy.

scholarly journals Tuberculous Lymphadenitis coexists with Non-Hodgkin Lymphoma

2020 ◽  
Vol 1 (2) ◽  
pp. 52
Author(s):  
Nenci Siagian ◽  
Bramantono Bramantono ◽  
Usman Hadi
Keyword(s):  
Septic Shock ◽  
Febrile Neutropenia ◽  
Extrapulmonary Tuberculosis ◽  
Cervical Lymphadenopathy ◽  
Common Symptom ◽  
Tuberculous Lymphadenitis ◽  
Non Hodgkin Lymphoma ◽  
Night Sweats ◽  
History Of ◽  
The Common

Tuberculous Lymphadenitis (TBLN) is most common extrapulmonary tuberculosis. The common symptom of TBLN is cervical lymphadenopathy which is known to mimic numerous pathological conditions like NHL. Coexistency TBLN and lymphoma is  a rare. A woman, 56 years old, had chief complaint of cervical masses since 2 months ago. She had history of weight loss, fever and night sweats but no history of chronic cough. From physical examination and supporting examination, the patient was diagnosed with TBLN coexists with NHL. She got antituberculosis drug (ATD) for 2 weeks before chemotherapy. The patient died of septic shock 9 days later after chemotherapy. From HPE examination, TBLN and NHL may show simillar feature so Zhiel-Neelsen staining and Immunohistochemical are important to confirm each disease. ATD was given to supress the mycobacterium activity before chemotherapy. However the patient had febrile neutropenia after chemotherapy and died of septic shock. Both TBLN and NHL may occur with simillar sign and symptom and HPE. Further examinations have to be done to confirm the diagnosis of both disesases. Although ATD had given to prevent Tb infection progresivity. On 7 days after chemotherapy she had febrile neutropenia and lead to death due to septic shock.

scholarly journals Cervical Lymphadenopathy in a Nonagenarian Woman: What to Think?

2019 ◽  
Author(s):  
Vanessa Meireles Chaves ◽  
Fernando Nogueira ◽  
Gilberto Pires da Rosa ◽  
Sofia Tavares ◽  
Inês Ferreira ◽  
...  
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Cervical Lymphadenopathy ◽  
Public Health Problem ◽  
Excisional Biopsy ◽  
The Elderly ◽  
Extensive Study ◽  
Tuberculous Lymphadenitis ◽  
Cervical Lymphadenitis ◽  
Presumptive Treatment ◽  
Cervical Lymph Nodes

Tuberculosis remains a worldwide public health problem. Cervical tuberculous lymphadenitis (TBL) or scrofula is the most common form of extrapulmonary tuberculosis, affecting the cervical lymph nodes. We report the case of a 93-year-old woman presenting with cervical adenopathies with 3 months duration. Fine needle aspiration (FNA) biopsy yielded a noncaseous granulomatous process, but was negative for Mycobacterium tuberculosis (MT). As the adenopathies had grown, an excisional biopsy was performed. An extensive study of infectious aetiologies was performed, including for MT, with a negative outcome. Owing to the persistence of cervical lymphadenitis with caseous granulomas, a diagnosis of TBL was strongly suspected and presumptive treatment was initiated. Afterwards, diagnostic confirmation was obtained by isolation of MT in the lymph node culture. The patient presented a favourable clinical outcome. This case highlights that a high index of suspicion is essential for the diagnosis of TBL, especially in the elderly, and emphasizes the importance of pursuing diagnostic confirmation, in which FNA and excisional biopsy plays a key role.

scholarly journals Rheumatoid Meningitis a Rare Extra-Articular Manifestation of Rheumatoid Arthritis: Report of 6 Cases and Literature Review

2020 ◽  
Vol 9 (6) ◽  
pp. 1625
Author(s):  
Mélanie Trabelsi ◽  
Xavier Romand ◽  
Mélanie Gilson ◽  
Mathieu Vaillant ◽  
Pierre-André Guerne ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Lumbar Puncture ◽  
Clinical Symptoms ◽  
Complete Recovery ◽  
High Rate ◽  
High Dose ◽  
Biologic Dmards ◽  
Oral Steroids ◽  
Fluid Attenuated Inversion Recovery ◽  
Rheumatoid Meningitis

Objectives. Central neurological manifestations of rheumatoid arthritis (RA) like rheumatoid meningitis (RM) are rare, little known and have a high rate of morbi-mortality. METHODS. We described six cases of RM that were directly related to RA activity after exhaustive assessment. RESULTS. They were mainly women, aged of 50 to 69. All were positive for anti-cyclic citrullinated peptide antibodies and half for rheumatoid factors. RA activity, duration, and treatments were heterogeneous including oral steroids, conventional synthetic disease modifying anti-rheumatic drugs (DMARDs) and biologic DMARDs. Symptoms were various, with acute or progressive beginning; main were: generalized or focal seizure (4/6), fever (3/6), headaches (3/6), and frontal syndrome (2/6). Imaging lesions were four leptomeningitis, one pachymeningitis, and one association of both. MRI usually showed hypersignal in various territories in T2-FLAIR (fluid attenuated inversion recovery) mode, and enhancement in T1-weighted mode after gadolinium injection. All patients had lumbar puncture that found sterile cerebrospinal fluid, no neoplasic cell, elevated cell count in 5/6 cases and elevated proteins concentration in 3/6 cases. Cerebral biopsy was possible for three patients, and definitively confirmed the diagnosis of aseptic lepto- or pachymenintis, excluding vasculitis and lymphoma. Different treatments were used like intravenous high dose steroids, immunoglobulins or biologic DMARDs, with variable clinical and imaging outcome: one death, one complete recovery, and four recoveries with sequelae. Conclusions. Clinical symptoms, imaging, lumbar puncture, and serological studies are often nonspecific, only histologic examination can confirm the diagnosis of RM. Any central neurological manifestation in RA patients, even in quiescent and ancient RA, should warn the physician.

scholarly journals Cervical Cat Scratch Disease Lymphadenitis in a Patient with Immunoglobulin M Antibodies to Toxoplasma gondii

2002 ◽  
Vol 9 (2) ◽  
pp. 496-498
Author(s):  
Mardjan Arvand ◽  
Ilkay Kazak ◽  
Sergije Jovanovic ◽  
Hans-Dieter Foss ◽  
Oliver Liesenfeld
Keyword(s):  
Toxoplasma Gondii ◽  
Clinical Symptoms ◽  
Bartonella Henselae ◽  
Cervical Lymphadenopathy ◽  
Immunoglobulin M ◽  
Cat Scratch Disease ◽  
Specific Immunoglobulin ◽  
Acute Toxoplasmosis

ABSTRACT We report on a young patient with chronic cervical lymphadenopathy and serological and histological evidence for infection with Bartonella henselae and Toxoplasma gondii. Serological follow-up studies, including testing for avidity of Toxoplasma-specific immunoglobulin G antibodies, assisted in the determination of the cause of the acute lymphadenitis. Our results suggest that the clinical symptoms were most likely due to cat scratch disease rather than to acute toxoplasmosis.

scholarly journals Clinical profile of cervical lymphadenopathy and to find diagnostic efficacy of fine-needle aspiration cytology, ultrasonography and histopathological examination

2020 ◽  
Vol 6 (3) ◽  
pp. 551
Author(s):  
Nitin Sharma ◽  
Maya Singh ◽  
Pritosh Sharma ◽  
Rahul Nahar ◽  
V. P. Goyal
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Cervical Lymphadenopathy ◽  
Needle Aspiration ◽  
Tuberculous Lymphadenitis ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Common Diagnosis ◽  
Granulomatous Lymphadenitis ◽  
Needle Aspiration Cytology

<p class="abstract"><strong>Background:</strong> Cervical lymphadenopathy is the sign of a disease process which involves lymph nodes that are anomalous in uniformity and dimensions. It is very vital to exercise fine-needle aspiration biopsy, histopathological investigation, and ultrasonography for the diagnosis of palpable lesions.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of 12-month duration from January 2018 to December 2018 in 61 patients presenting with cervical lymphadenopathy admitted in the ENT Department at Geetanjali Medical College and Hospital, Udaipur.  </p><p class="abstract"><strong>Results:</strong> In biopsy, most common diagnosis was chronic granulomatous lymphadenitis i.e. in 62.3% of the patients. As compared to biopsy, fine-needle aspiration cytology (FNAC) showed chronic granulomatous lymphadenitis in 46% of the patients, with overall sensitivity of 91.1%, and specificity of 60.0%. and accuracy of 88.5%. Whereas ultrasonography (USG) reported, 64% cervical lymphadenopathy in patients, with overall sensitivity came out to be 91.1%, specificity to be 40.0%, accuracy was 86.9%.</p><p class="abstract"><strong>Conclusions:</strong> Present study showed that biopsy is the gold standard procedure for diagnosis of cervical lymphadenopathy lesions followed by FNAC, USG. Tuberculous lymphadenitis was most common diagnosis made by the diagnostic modalities.</p>

Baffled with fever and lymphadenopathy: neither infection nor malignancy, think Kikuchi disease

2021 ◽  
Vol 14 (1) ◽  
pp. e238914
Author(s):  
Ali Hussain ◽  
Mohsin Gondal ◽  
Hira Yousuf ◽  
Mubashar Iqbal
Keyword(s):  
Young Women ◽  
Cervical Lymphadenopathy ◽  
Complete Recovery ◽  
Symptomatic Treatment ◽  
Lymph Node Biopsy ◽  
Asian Woman ◽  
Unknown Aetiology ◽  
Benign Condition ◽  
Node Biopsy ◽  
Clinical Investigations

Kikuchi disease is a rare, benign condition of unknown aetiology, which usually involves young women and is characterised by cervical lymphadenopathy and fever. Herein, we are reporting a case of a young Asian woman, who presented with fever and lymphadenopathy raising possibility of either infection or malignancy but after appropriate clinical investigations including lymph node biopsy, it turned out to be Kikuchi disease. She made an uneventful complete recovery with only symptomatic treatment.

Abstract 193: Hemophagocytic lymphohistiocytosis following kawasaki disease:Differential Diagnosis in IVIG Refractory Kawasaki Disease

Circulation ◽  
2015 ◽  
Vol 131 (suppl_2) ◽  
Author(s):  
Hyun Ok Jun ◽  
Eun Kyung Cho ◽  
Jeong Jin Yu ◽  
So Yeon Kang ◽  
Chang Deok Seo ◽  
...  
Keyword(s):  
Bone Marrow ◽  
Coronary Artery ◽  
Kawasaki Disease ◽  
Skin Rash ◽  
Hemophagocytic Lymphohistiocytosis ◽  
Clinical Symptoms ◽  
Early Recognition ◽  
Cervical Lymphadenopathy ◽  
Inflammatory Disorder ◽  
Laboratory Findings

Introduction: Hemophagocytic lymphohistiocytosis(HLH) is a systemic inflammatory disorder characterized by uncontrolled histiocytic proliferation, hemophagocytosis and up-regulation of inflammatory cytokines. Thus, both HLH and Kawasaki disease(KD) are characterized by prolonged fever, and are diagnosed by a clinical and laboratory scoring system, concurrent manifestation of HLH and KD has been described in the literature. We describe two cases of children who diagnosed as KD initially, but after intravenous gamma globulin(IVIG) failed to produce clinical response, were found to have HLH. Case report: A 3-year-old boy who had previous KD history 5 months ago was admitted for 9day fever and skin rash. His symptoms were fulfilled KD criteria, and echocardiography showed dilated right coronary artery of 4.2mm. He was treated with 2 cycles of IVIG until fever subsided. However, 2 days later, he got fever again and cytopenia(Hb<9.0), hypertriglyceridemia, high level of ferritin was shown and had splenomegaly on physical examination. In the suspicion of HLH, bone marrow biopsy was done and revealed hemophagocytosis, consistent with HLH. A second case of 11-month-old boy admitted for 8-day fever with Kawasaki feature. Although, he showed incomplete feature(fever, skin rash, conjunctival injection, cervical lymphadenopathy), echocardiography showed dilated left main coronary artery(3.5mm) and treated with IVIG. However, 2days after IVIG administration, he was still pyrexial. The laboratory findings fulfilled 5 diagnostic criteria of HLH; bicytopenia(anemia, thrombocytopenia), hypofibrinogenemia, hyperferritinemia, hemophagocytosis in bone marrow, raised level of soluble IL-2 receptor. In both cases, the patients treated according to the HLH protocol 2004, and after that clinical symptoms and laboratory findings were improved. Several causes of febrile illness, EBV, CMV, rubella, parvo-viral infection, for example, were excluded. Comment: There is considerable overlap between the clinical syndromes of KD and HLH and early recognition and treatment of these two disease entity is imperative to avoid fatal outcomes in severe cases. Thus, these should both be considered and excluded in any child with unremitting fever and rash.

Disease Spectrum of Cervical Lymphadenopathy in adults

2021 ◽  
Vol 15 (11) ◽  
pp. 2853-2855
Author(s):  
Rabia Amin Butt ◽  
Zonaira Rathore ◽  
Afia Sarwar ◽  
Faiza Azam ◽  
Faria Waqar Khan ◽  
...  
Keyword(s):  
Hodgkin Lymphoma ◽  
Tertiary Care ◽  
Cervical Lymphadenopathy ◽  
Diagnostic Tools ◽  
Tuberculous Lymphadenitis ◽  
Care Hospital ◽  
Inclusion Criteria ◽  
Non Hodgkin Lymphoma ◽  
Malignant Lesions ◽  
Age Range

Aim: To determine the frequency of different diseases resulting in cervical lymphadenopathy in specimens of patients presenting in tertiary care hospital. Methodology: It was a cross sectional study conducted at the histopathology section of the pathology department of Services Institute of Medical Sciences/Services Hospital Lahore. The study was approved by the ethical committee of the institution. The study was completed in six months.100 cases fulfilling the inclusion criteria were registered. Inclusion criteria included patients above 16 years of age, patients from both sexes, unilateral or bilateral irrespective of duration. Lymph nodes less than 1cm were not included in the study. Informed consent was taken. Both FNAC and Biopsy were used as diagnostic tools. All the data was analysed with SPSS version 11. Results: During a period of six months, a total of 100 cases of cervical lymphadenopathy were studied. These included 75 benign and 25 malignant cases. Out of benign cases 53% were diagnosed as tuberculous lymphadenitis. About 81.3% were in the age range of 16-25 years and 18.7% were in the age range of 26-35 years. 22% cases were diagnosed as reactive lymphadenitis. About 54.54% of these patients were in the age range of 16-25 years and 45.46% were in the age range of 26-35 years. The highest frequency among malignant lesions consisted of Non-Hodgkin lymphoma 16% followed by Hodgkin lymphoma 5% and metastatic disease 4%.The age range of malignant lesions was in the range of 36-78 years. Conclusion: Our study concludes that cervical lymphadenopathy is the common clinical presentation in our setup and tuberculosis is the commonest cause. Keywords: Hodgkin lymphoma, Non-Hodgkin lymphoma, Fine needle aspiration cytology

Posterior reversible encephalopathy syndrome (PRES) presenting as Status Epilepticus in a case of Autoimmune Hemolytic Anemia (AIHA): A Case report

2021 ◽  
Vol 12 (6) ◽  
pp. 102-106
Author(s):  
Sameera Dronamraju ◽  
Shilpa Gaidhane ◽  
Aayush Somani ◽  
Sourya Acharya
Keyword(s):  
Status Epilepticus ◽  
Hemolytic Anemia ◽  
Posterior Reversible Encephalopathy Syndrome ◽  
Autoimmune Hemolytic Anemia ◽  
Vasogenic Edema ◽  
Complete Recovery ◽  
Young Female ◽  
Posterior Reversible Encephalopathy ◽  
Oral Steroids ◽  
Reversible Encephalopathy

Posterior reversible encephalopathy syndrome (PRES) is a neurotoxic state, caused by imbalance in autoregulation of posterior cerebral circulation. We report a case of young female, presented at emergency department with complains of nausea, vomiting and generalized tonic clonic seizures prior to admission. During the course of hospital stay patient landed in status epilepticus which was treated appropriately. Patient’s magnetic resonance imaging (MRI) was done which had classical features of vasogenic edema in occipital and parietal region, suggestive of PRES. She was a known case of autoimmune hemolytic anemia thatwas treated with multiple blood transfusions and low dose oral steroids. She was discharged after complete resolution of symptoms with the advice to follow up in medicine outpatient department. Our case describes about autoimmune hemolytic anemia in which occurrence of PRES is uncommon. Early diagnosis and robust treatment can prevent permanent damage to the brain, and is often associated with complete recovery.

Cervical lymphadenopathy: scrofula revisited

2008 ◽  
Vol 123 (7) ◽  
pp. 764-767 ◽  
Author(s):  
R Khan ◽  
S H Harris ◽  
A K Verma ◽  
A Syed
Keyword(s):  
Fine Needle Aspiration ◽  
Fine Needle Aspiration Cytology ◽  
Extrapulmonary Tuberculosis ◽  
Cervical Lymphadenopathy ◽  
Polymerase Chain Reaction Analysis ◽  
Needle Aspiration ◽  
Cervical Lymphadenitis ◽  
Aspiration Cytology ◽  
Fine Needle ◽  
Needle Aspiration Cytology

AbstractBackground:The commonest form of extrapulmonary tuberculosis is tubercular cervical lymphadenitis, or scrofula.Methods and results:A total of 1827 patients with cervical lymphadenopathy who presented to various out-patients clinics of our institution were studied over a three-year period. Eight hundred and ninety-three (48.87 per cent) of these patients had lesions of tubercular origin. The most common observation was unilateral, matted adenopathy in female patients aged between 11 and 20 years and without constitutional symptoms of tuberculosis. Posterior triangle nodes were affected in 43.8 per cent of cases, followed by upper deep cervical nodes in 33.9 per cent. Fine needle aspiration cytology constituted the main diagnostic tool, with a positive yield in 90 per cent of patients. Polymerase chain reaction analysis was performed in 126 patients, with a sensitivity of 63 per cent. Only 18 per cent of patients had associated pulmonary tuberculosis, the rest having isolated involvement of cervical nodes. Medical treatment with anti-tubercular drugs for a period of six months formed the mainstay of treatment and cure. Surgical management was reserved for selected refractory patients.Conclusion:Tubercular cervical lymphadenitis can readily be diagnosed by fine needle aspiration cytology, a simple and cost-effective test. The disease can be cured completely by a short course of anti-tubercular chemotherapy, without surgical intervention.

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