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.

Cervical Adenitis

1985 ◽  
Vol 7 (1) ◽  
pp. 13-24
Author(s):  
Andrew M. Margileth
Keyword(s):  
Cervical Lymphadenopathy ◽  
Staphylococcal Infection ◽  
The Body ◽  
Cervical Lymphadenitis ◽  
Neck Node ◽  
Cervical Lymph Nodes ◽  
Cervical Adenitis ◽  
Viral Illness ◽  
Infection And Inflammation ◽  
Reactive Hyperplasia

Children with acutely tender and inflamed cervical lymph nodes are observed commonly by family physicians and pediatricians. Cervical lymphadenitis is usually associated with a systemic viral illness and subsides within a few days to 2 weeks. Bacterial adenitis, seen less often, is usually due to (β-hemolytic streptococcal or to staphylococcal infection. However, when a neck node remains enlarged following a systemic illness or when a nontender regional cervical node (adenopathy) persists longer than 2 or 3 weeks with or without associated illness, the physician and parents become worried. Concern is enhanced if the nodes increase in size or number. Infection and inflammation are the most common causes for persistent chronic (3 or more weeks' duration) lymphadenopathy in children. Whereas neoplasm is rare (1.4%) in the child or adolescent less than 17 years of age with a superficial lump on any part of the body, maligancy (Hodgkin disease, lymphoma, neuroblastoma) was found in 31 (13%) of 239 enlarged cervical nodes in similar-aged children at the same institution. Congenital and acquired cysts, pilomatrixomas, and benign neoplasms (lipoma, neurofibroma, lymphangioma) account for the majority of noninflammatory lesions in the neck in children and adolescents. However, most cervical lymphadenopathy in children is due to adenitis or reactive hyperplasia in response to an infection.

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.

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.

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 Immunocytochemical Study of Rabbit-Polyclonal to Mycobacterium Tuberculosis, AB905: Improving Diagnostic of Tuberculous Lymphadenitis

2021 ◽  
Vol 21 (2) ◽  
pp. 95-101
Author(s):  
Humairah Medina Liza Lubis ◽  
Emni Purwoningsih ◽  
Ance Roslina ◽  
Muhammad Al Anas
Keyword(s):  
Mycobacterium Tuberculosis ◽  
Predictive Value ◽  
Extrapulmonary Tuberculosis ◽  
Clinical History ◽  
Excisional Biopsy ◽  
Needle Aspiration ◽  
Cross Sectional Study ◽  
Tuberculous Lymphadenitis ◽  
Immunocytochemical Study ◽  
Cross Sectional

Tuberculous lymphadenitis (TBLN) is the most common form of extrapulmonary tuberculosis. However, the optimal diagnosis using Fine-Needle Aspiration Cytology (FNAC) or excisional biopsy is uncertain. This research aims to improve the diagnostic of TBLN with FNAC and immunocytochemistry (ICC) compared to the response to antituberculosis therapy. The cross-sectional study involved 43 patients with the criteria for TBLN diagnosis based on the appropriate clinical history of tuberculosis and indicative cytological results. Immunocytochemical examination employed rabbit-polyclonal to Mycobacterium tuberculosis (MTB) antibody (AB905). The MTB expression was found in 35 out of 43 cases (81%) that appropriate cytological features of the tuberculosis process. Meanwhile, eight out of 43 cases (19%) did not express MTB. Diagnostic tests for lesions with a positive cytologic appearance of TBLN and ICC were compared to the response to anti-tuberculosis therapy, revealing the sensitivity, specificity, positive predictive value, and negative predictive value of 95.2%, 75%, 95.2%, and 17%, respectively. Besides, Fisher's exact tests utilized to identify the relationship between two variables; p 0.05 was considered significant. This research found immunocytochemical study was a sensitive and specific tool for improving the diagnostic of TBLN.

scholarly journals Role of FNAC in the diagnosis of cervical lymphadenopathy

2017 ◽  
Vol 5 (12) ◽  
pp. 5237
Author(s):  
Chandralekha Janagam ◽  
Bhagyalakshmi Atla
Keyword(s):  
Cervical Lymphadenopathy ◽  
Needle Aspiration ◽  
Clinical Findings ◽  
Common Disease ◽  
Tuberculous Lymphadenitis ◽  
Age Group ◽  
Cervical Lymph Nodes ◽  
Specific Distribution ◽  
Neoplastic Lesions ◽  
Granulomatous Lymphadenitis

Background: Cervical lymphadenopathy is one of the commonest presentations in inflammatory and neoplastic disorders. Fine Needle Aspiration Cytology (FNAC) is simple, quick, inexpensive and minimally invasive OPD technique used for establishing the etiology of cervical lymphadenopathy. In this study we describe cytomorphological patterns of cervical lymph nodes and its utility in establishing diagnosis. Objectives of present study were to assess the distribution of various cytomorphological patterns of cervical lymphadenopathy and to assess the age specific distribution of various cytomorphological patterns of cervical lymphadenopathy.Methods: This study was carried out in the Department of Pathology, Andhra Medical College on 200 cases of cervical lymphadenopathy over a period of three months from August - October 2017. FNAC diagnosis was correlated with relevant clinical findings and investigations.Results: Total 200 cases were studied. Of these, 170 (85%) were inflammatory and 30 (15%) were neoplastic. Reactive non-specific lymphadenitis was the most common disease found in 95 (47.5%) patients followed by tuberculous lymphadenitis in 60 patients (30%) and granulomatous lymphadenitis in 15 patients (7.5%). Among neoplastic lesions, metastatic tumours were reported in 26 patients (13%) and Lymphoproliferative disorder/Lymphoma was reported in 4 patients (2%). Highest incidence of cervical lymphadenopathy was found in patients of 10-39 years age group, among which most of the cases were non-specific lymphadenitis followed by tuberculous lymphadenitis. Amongst the neoplastic lesions, most of the cases were in the age group of 40-79 years.Conclusions: FNAC is simple, safe, reliable procedure for diagnosis of cervical lymphadenopathy.  

scholarly journals UTILITY OF ULTRASONOGRAPHY DIAGNOSIS FOR CERVICAL LYMPHADENOPATHY IN CENTRAL INDIAN POPULATION- A HOSPITAL BASED OBSERVATIONAL STUDY

2019 ◽  
Vol 3 (5) ◽  
Author(s):  
Dr. Neerja Jain Sudhakar ◽  
Dr. C. Sudhakar ◽  
Dr. Priyadershini Rangari
Keyword(s):  
Lymph Nodes ◽  
Indian Population ◽  
Cervical Lymphadenopathy ◽  
Excision Biopsy ◽  
Tuberculous Lymphadenitis ◽  
Metastatic Node ◽  
Cervical Lymph Nodes ◽  
Round Shape ◽  
Time Linear ◽  
Keywords Ultrasonography

Background: Cervical lymph nodes are frequently involved in a number of disease conditions. The most commonly seen causes of cervical lymphadenopathy are tuberculosis, distant metastasis and lymphoma. Objective: To assess the usefulness of ultrasonography in the differential diagnosis of cervical lymphadenopathy. Methods: ultrasonography of cervical lymph nodes was performed with a real-time linear scanner using a 7.5- or 11-MHz probe. Ultrasonography findings were retrospectively reviewed in 432 lymphnodes of 120 patients. USG findings were reevaluated by FNAC, CECT neck, MRI and core needle biopsy wherever required. Results: out of 432 lymphnodes; 108 tuberculous lymphadenitis, 46 metastatic, 59 lymphoma, 114 inflammatory and 105 normal lymph nodes were observed. Ultrasonography features were found to be stronger in tubercular, metastatic and lymphomatous lymphnodes. Hypoechoic center was prominently observed in tubercular and metastatic form. In most of the patients, FNAC result was equivocal and a subsequent excision biopsy of the lymph node was carried out to confirm the diagnosis. Lymphadenitis was diagnosed with a sensitivity of 100% and a specificity of 100%. Conclusion: This study concluded that cervical group of lymph nodes with ultrasonography features such as round shape, absence of hilar echo, sharp nodal borders, Hypoechoic internal echogenicity and presence of intranodal necrosis were highly suggestive of metastatic cervical lymph nodes. Ultrasonography along with other radiological and histopathological parameters can be very effective in early diagnosis of high risk diseases. Keywords: Ultrasonography; Tuberculous Lymphadenitis; Malignant Lymphoma; Metastatic Node

scholarly journals Causes and Presentation Of Cervical Lymphadenopathy

2018 ◽  
Vol 4 (2) ◽  
pp. 31-35
Author(s):  
Arifullah Bangash ◽  
Syed Zafar Hassan ◽  
Ghulam Muhammad
Keyword(s):  
Lymph Nodes ◽  
Teaching Hospital ◽  
Acute Inflammation ◽  
Cervical Lymphadenopathy ◽  
Excisional Biopsy ◽  
Descriptive Study ◽  
Lymph Node Involvement ◽  
Cervical Lymph Nodes ◽  
Node Involvement ◽  
Reactive Hyperplasia

OBJECTIVETo determine the proportion of cervical lymphadenopathy in systemic diseases, their presentation and investigative tools.METHODOLOGYThis descriptive study was carried out from 1st July 2014 to 30 June 2017 in ENT and head and neck department Naseer Teaching Hospital and Town Teaching Hospital, Peshawar. Total of 270 patients with enlarged cervical lymph nodes, of either sex and of any age were approached for inclusion into the study. Patients with suspected acute inflammation were given a trial of antibiotic and followed for two weeks were excluded from the study. Excisional biopsy of the lymph nodes was performed in all these patients with six weeks or more duration.RESULTSIn our study out of 270 patients, 158 (58.5%) were males and the majority of patients (63.3%) had ages from 11-40 years. Tuberculous cervical lymphadenopathy was diagnosed in 145 (53.7%) patients, reactive hyperplasia in 53 (19.6%), lymphoma in 32 (11.8 %,) metastasis to cervical lymph nodes in 30 (11.1%), sarcoidosis in 7 (2.6%) and other very rare conditions as Kawasaki, Kikuchie and Rosi Dorfman were found in only one of each (0.4%). About 136 (50.4%) of the patients had involvement of multiple lymph nodes while 134 (49.6%) had single swelling. The matted lymph nodes were found in 162 (60%) whereas discrete lymph nodes were found in only 108 (40%) cases. Cold abscess was found in 19 (7%) of patients.CONCLUSIONTuberculosis is the commonest cause of cervical lymphadenopathy, with the majority of these patients having multiple lymph node involvement. In children, usually cervical lymphadenopathy is reactive or infective while in older age mostly metastatic.

scholarly journals PHENYTOIN-ASSOCIATED LYMPHOADENOPATHY MIMICKING A PERIPHERAL T-CELL LYMPHOMA

2010 ◽  
Vol 2 (2) ◽  
pp. e2010028 ◽  
Author(s):  
Mark E. Johns ◽  
Lynn C. Moscinski ◽  
Lubomir Sokol
Keyword(s):  
Bone Marrow ◽  
T Cells ◽  
T Cell ◽  
Cell Population ◽  
Peripheral Blood ◽  
Mononuclear Cells ◽  
Cervical Lymphadenopathy ◽  
Excisional Biopsy ◽  
Whole Body ◽  
Cervical Lymph Nodes

We report a case of phenytoin-induced pseudolymphoma in a 28-year-old male with a history of autism and seizure disorder.  The patient presented with bilateral cervical lymphadenopathy that was shown to be moderately to markedly FDG-avid on a whole body PET/CT scan.  Flow cytometry analysis of peripheral blood and bone marrow mononuclear cells detected identical T cell population with aberrant immunophenotype.  Additionally, a TCR beta gene was found to be clonally rearranged in both peripheral blood and bone marrow supporting a clonal origin of atypical T cells. However, no such clonal population of T-cells could be detected in a pathologic specimen obtained from an excisional biopsy of one of the patient’s cervical lymph nodes. After discontinuing the patient’s phenytoin, his lymphadenopathy has nearly completely resolved and circulation clonal T cell population disappeared with 12 months of follow-up.

“TUBERCULOSIS – A COMMON GRANULOMATOUS DISEASE AT UNCOMMON SITES: A COMPREHENSIVE HISTOCYTOLOGICAL STUDY IN A TERTIARY CARE HOSPITAL OF CENTRAL INDIA”

2021 ◽  
pp. 65-67
Author(s):  
Anki Saluja ◽  
Rashmi Gupta ◽  
Chitrangi P. Barpande ◽  
B. P. Singh
Keyword(s):  
Extrapulmonary Tuberculosis ◽  
Tertiary Care ◽  
Cervical Lymphadenopathy ◽  
Central India ◽  
Care Hospital ◽  
Granulomatous Disease ◽  
Cervical Lymph Nodes ◽  
Submandibular Region ◽  
Common Location ◽  
High Index Of Suspicion

Background: Tuberculosis (TB) is a common granulomatous disease caused by Mycobacterium tuberculosis, which primarily affects lungs in about 80 % of cases. Extrapulmonary tuberculosis (EPTB) is dened according to WHO classication criteria as an infection by M. tuberculosis which affects tissues and organs outside the pulmonary parenchyma. Among EPTB the most common location is cervical lymphadenopathy (63- 77%). Involvement of other organs or location is extremely rare, even in countries in which tuberculosis is endemic. Aim:To study the common granulomatous lesion, tuberculosis at uncommon sites on histological and cytological preparations. Materials and methods: A retrospective study of 76 cases (presented during two years), of extrapulmonary tuberculosis excluding lung, pleura and cervical lymph nodes was undertaken. Cases were selected according to the inclusion and exclusion criteria. After morphological diagnosis, cases were subjected to modied ZN staining. This was correlated with ultrasonography and Cartridge Based Nucleic Acid Amplication Test (CBNAAT) wherever available. Results: Majority of cases (63.2%) were females. Most of the cases (28/60) belonged to the age group between 21 and 30 years. Most common of the uncommon sites were axilla followed by breast and submandibular region. Conclusions: Extrapulmonary tuberculosis is quite common and keeping a high index of suspicion helps in early diagnosis and hence early treatment of this disease.

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