EVALUATION OF PATIENTS WITH LYMPH NODE TUBERCULOSIS

Yıl 2013, Cilt: 18 Sayı: 3, 118 - 122, 10.01.2013

Mehmet Garça , Mehmet Aslan , Guner Demir Suayip Bilgen Muhsin Uysal

Öz

Abstract

Background: Lymph node tuberculosis (LNT) is a disease in which there is chronic granulomatous inflammation of the lymph nodes. The aim of the present study is retrospectively review the epidemiologic, clinical and laboratory features of patients diagnosed with LNT.  

Methods:The records of 138 patients admitted to tuberculos dispensary between 2005 and 2010 with the diagnosis of tuberculosis were reviewed retrospectively and 21 (15,2%) LNT cases were identified.          

Results: Twenty one (15,2%) cases were identified with LNT. Thirteen were female (61,9%), 8 (38,1%) were male and mean age was 41 ± 21 years. The female to male ratio of LNT cases was 1.625 (13/8).  The most common complaint was palpable mass on neck. The cervical lymph nodes alone were the most frequently involved; in 15 (71,5%) patients. Contact history with tuberculosis cases was determined only 2 cases (9,5%) and two cases had history of pulmonary tuberculosis (9,5%). After confirmation of diagnosis all patients were treated with combined anti-tuberculous chemotherapy for at least six months.

Conclusions: LNT is seen more frequent in female than male. It should be considered in the differential diagnosis of the neck masses. 

Key words: tuberculosis, lymph node, neck mass

Anahtar Kelimeler

Extrapulmonary tuberculosis, lymph node tuberculosis, neck mass

Kaynakça

• WHO. Global tuberculosis control: surveillance, planning, financing. WHO report 2007 (WHO/HTM/TB/2007.376).
• Miziara ID. Tuberculosis affecting the oral cavity in Brazilian HIV-infected patients. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2005; 100: 179-182.
• Jha BC, Dass A, Nagarkar NM, et al. Cervical tuberculous lymphadenopathy: Changing clinical pattern and concepts in management. Postgrad Med J 2001; 77: 185-187.
• Shapiro AL, Pincus RL. Fine-needle aspiration of diffuse cervical lymphadenopathy in patients with acquired immunodeficiency syndrome. Otolaryngol Head Neck Surg 1991; 105: 419-421.
• Pehme L, Hollo V, Rahu M, et al. Tuberculosis during fundamental societal changes in Estonia with special reference to extrapulmonary manifestations. Chest 2005; 127: 1289-1295.
• Ilgazli A, Boyaci H, Basyigit I, Yildiz F. Extrapulmonary tuberculosis: clinical and epidemiologic spectrum of 636 cases. Arch Med Res 2004; 35: 435-441.
• Grzybowski S, Allen E. History and importance of scrofula. Lancet 1995; 346: 1472-1474.
• Lau SK, Kwan S, Lee J, et al. Source of tubercle bacilli in cervical lymph nodes: a prospective study. J Laryngol Otol 1991; 105: 558-561.
• Sloane MF. Mycobacterial Lymphadenitis. In: Rom WN, Garay SM, eds. Tuberculosis. Boston/New York/Toronto/London: Little, Brown and Company; 19 p. 577-583. Cruz AT, Starke JR. Clinical manifestations of tuberculosis in children. Paediatr Respir Rev 2007; 8: 107Hooper AA. Tuberculous peripheral lymphadenitis. Br J Surg 1972; 59: 353-359.
• Al-Sherhani AM. Mycobacterial infections of the head and neck: presentation and diagnosis. Laryngoscope 2001; 111: 2012-2016.
• Polesky A, Grove W, Bhatia G. Peripheral tuberculous lymphadenitis: epidemiology, diagnosis, treatment, and outcome. Medicine (Baltimore) 2005; 84: 3503
• Long NH, Diwan VK, Winkvist A. Difference in symptoms suggesting pulmonary tuberculosis among men and women. J Clin Epidemiol 2002; 55: 115-120.
• Matsushita Y, Ikeda N, Kurasawa T, et al. The characteristics of clinical features of pulmonary tuberculosis in female. Kekkaku 1996; 71: 391-398.
• Ammari FF, Bani Hani AH, Ghariebeh KI. Tuberculosis of the lymph glands in the neck: a limited role for surgery. Otolaryngol Head Neck Surg 2003; 128: 576-580.
• Ramanathan VD, Jawahar MS, Paramasivan CN, et al. A histological spectrum of host responses in tuberculous lymphadenitis. Indian J Med Res 1999; 109: 212-220.
• Dean K. Self-care components of lifestyles: the importance of gender, attitudes and the social situation. Soc Sci Med 1989; 29: 137-152.
• Bothamley G. Sex and gender in the pathogenesis of infectious tuberculosis. A perspective from immunology, microbiology and human genetics. In: Diwan VK, Winkvist A, editors. Gender and tuberculosis. NHV report. Goteborg, Sweden: Nordic School of Public Health; 1998, p. 41-53.
• Williams RG, Douglas-Jones T. Mycobacterium marches back. J Laryngol Otol 1995; 109: 5-13.
• Martin PD. The tuberculin skin test. N Z Med J 1994; 107: 310-311.
• Davis SD, Yankelevitz DF, Williams T, Henschke CI. Pulmonary tuberculosis in immunucompromised hosts: epidemiological, clinical, and radiological assessment. Semin Roentgenol 1993; 28: 119-130.
• Ibekwe AO, Al Shareff ZA, Al Kindy S. Diagnostic problems of tuberculosis cervical adenitis (scrofula). Am J Otol 1997; 18: 202-205.
• Dasgupta A, Ghosh RN, Poddar AK, et al. Fine needle aspiration cytology of cervical lymphadenopathy with special reference to tuberculosis. J Indian Med Assoc 1994; 92: 44-46.