Tuberculous lymphadenitis

Yıl 2010, Cilt: 20 Sayı: 4, 184 - 190, 20.08.2010

İbrahim Sayın Sultan Bişkin Taliye Çakabay Zahide Mine Yazıcı Ayşenur Meriç Fatma Tülin Kayhan

Öz

Objectives: In this study, we evaluate tuberculosis Tbc lymphadenitis diagnosed patients age, gender, contact history, history of smoking, socioeconomic status, lymphadenitis localization, imaging techniques, fine needle aspiration biopsy FNAB and excisional biopsy results. Patients and Methods: Between February 2006 and February 2008 104 patients were operated to determine the etiology of their neck masses. Twenty-six patients 16 females, 10 males; mean age 36.9 years; range 16 to 52 years who were diagnosed as Tbc lymphadenitis according to pathology results were included in the study. Ear, nose and throat examinations were performed in all patients routinely. Hemogram, biochemical and serological tests were performed. The patients were evaluated with anterior-posterior chest radiographs and purified protein derivative PPD by chest diseases consultation imaging methods and FNAB was performed. All patients diagnosed with excisional biopsy of neck mass. During the operation, tissue culture and ZiehlNeelsen method for staining was prepared. Results: Out of 26 patients eight had a history of contact with Tbc. One person had previously lung Tbc. Six patients had previously received treatment because of Tbc lymphadenitis, but didn’t complete the treatment. Neck ultrasonography and neck computed tomography detected a solid mass in 16 patients and cystic mass in 10 patients. The 24 patients were evaluated as positive PPD >10 mm . None of the patients had an association between active pulmonary Tbc and Tbc lymphadenitis. Conclusion: Suspicion is the most important step in the diagnosis of Tbc lymphadenitis. In patients with low socioeconomic status, previous Tbc contact, tabacco usage, suppressed immune system, and particularly in those with drainage from neck masses, Tbc lymphadenitis should be considered in the differential diagnosis.

Anahtar Kelimeler

Computed tomography, mycobacterial cervical lymphadenitis, tuberculosis, lymph node/diagnosis/drug therapy/physiopathology

Tüberküloz lenfadenitleri

Öz

Amaç: Bu çalışmada tüberküloz Tbc lenfadenit tanısı konulan hastaların yaşı, cinsiyeti, temas öyküsü, sigara öyküsü, sosyoekonomik durumu, lenfadenitin yerleşim yeri, görüntüleme yöntemleri, ince iğne aspirasyon biyopsisi İİAB ve eksizyonel biyopsi sonuçları değerlendirildi.Hastalar ve Yöntemler: Şubat 2006 ile Şubat 2008 tarihleri arasında 104 hasta boyun kitlelerinin etyolojisinin saptanması amacı ile ameliyat edildi. Patoloji sonucunda Tbc lenfadenit tanısı konulan 26 hasta 16 kadın, 10 erkek; ort. yaş 36.9 yıl; dağılım 16-52 yıl çalışmaya dahil edildi. Bütün hastaların kulak burun boğaz muayeneleri rutin olarak yapıldı. Hemogram, biyokimya ve serolojik testleri yapıldı. Hastalar ön-arka akciğer grafileri, PPD Purified protein derivative ve göğüs hastalıkları konsültasyonu görüntüleme yöntemleri ile İİAB yapılarak değerlendirildi. Tüm hastalara tanı boyun kitlesinden yapılan eksizyonel biyopsi ile konuldu. Ameliyat sırasında Ziehl-Neelsen yöntemiyle boyama ve doku kültürü için materyal alındı.Bulgular: Yirmi altı hastanın sekizinde Tbc ile temas öyküsü vardı. Bir kişi daha önce akciğer Tbc’si geçirmişti. Altı hasta daha önce Tbc lenfadeniti nedeni ile tedavi almış ancak tedavisini tamamlamamıştı. Boyun ultrasonografisi ve boyun bilgisayarlı tomografisinde hastaların 16’sında solid 10’unda ise kistik kitle saptandı. Yirmi dört hasta ise pozitif PPD olarak >10 mm değerlendirildi. Hastaların hiçbirinde Tbc lenfadenitle aktif akciğer Tbc birlikteliği saptanmadı.Sonuç: Şüphe Tbc lenfadenitinin tanısında en önemli adımdır. Sosyoekonomik durumu kötü olan daha önce Tbc temas öyküsü olan, sigara kullanan, immün sistemi baskılanmış olan hastalarda ve özellikle boyun kitlesinden akıntı tanımlayanlarda Tbc lenfadenit, ayırıcı tanıda düşünülmelidir

Anahtar Kelimeler

Bilgisayarlı tomografi, mikobakteriyel servikal lenfadenit, tüberküloz, lenf nodu/tanı/ilaç tedavisi/fizyopatoloji

Kaynakça

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