Approach to lymphadenopathy: how to diagnose tuberculosis lymphadenitis

Abstract

lymphadenopathy is considered as abnormal finding local or generalized that can becaused by neoplasm or infection, as tuberculosis lymphadenitis. Cervical localization has prevalence
 in the variety of disorders, can has a similar kind of clinical presentation and to differentiate them be-comes extremely difficult. We provided a case report of the new onset of extrapulmonary tuberculosis
 lymphadenitis in 42-year-old Indian man. The patient complained of multiply enlarged painful lymphnodes on left anterior neck and was also concerned about sore throat persistent for a year. Objectiveexamination and analysis were without evident inflammatory signs. Previous ultrasound, pulmonaryand abdominal CT-scan investigations also revealed conglomerate of left mediastinal lymph nodes,moderate splenomegaly. The preliminary diagnosis of lymphoma was excluded due to confirmationof typical tuberculosis lymphadenitis with specific testing and morphological changes of the resected
 lymphatic node. Sputum microscopy was found to be negative, which meant that the patient was neg-ative for social transmission of tuberculosis. Affected lymph nodes resolved completely after appro-priate therapy during one-year treatment. This case report of extrapulmonary tuberculosis highlights
 the importance of tissue diagnosis in unclear situations. We used clinical protocol for unspecifiedlymph node enlargement as complete history taking and physical examination that is preliminary fordiagnosis, while laboratory tests, imaging diagnostic methods and tissue samplings are gold standardevaluation for definite lymphadenopathy. Tuberculosis lymphadenitis is popularly known as collarstud abscess and is the most common benign cause of cervical lymphadenopathy in endemic areas.This observation determined the details of the immunocompromised state of the patient, conclusionwas supported by the evidence of Pseudomonas putida associated pharyngitis. The main differentialsigns between lymphoma as immunoproliferative disorder and infectious tuberculosis lymphadenitiswere provided.