Separated Axillary Tuberculous Lymphadenitis: A Case Report

Samer Makki Mohamed Al-Hakkak

doi:10.11648/j.js.20170502.12

Abstract

Tuberculosis (TB) still accounts for a high burden disease. It has been estimated that one third of the world population is infected with Mycobacterium tuberculosis, the most residing in developing countries. Separated axillary tuberculous lymphadenopathy is rare and described in patients without proof of previous or outstanding tuberculosis anywhere in the body. TB was supposed to be considered in the differential diagnosis of patients who present with axillary lymphadenopathy, especially in the endemic areas of Tuberculosis. Ultrasonography features of the axillary lymph node in our patient were not as helpful in diagnosis as the biopsy of the lymph node. Axillary tuberculous lymphadenitis diagnosis depends on the complete pathological examination. It remains both diagnostic and therapeutic challenge because it mimics other pathologic processes and yields inconsistent physical and laboratory findings. Diagnosis is difficult often requiring biopsy.

Highlights

Extra pulmonary TB accounts for about 7-30% of TB cases and lymphadenitis accounts for 17-43% of cases
Viral screen done for both hepatitis and HIV, So patient proceed for open biopsy, She had left axillary lymph node biopsy; clinical data and gross examination showed single piece of tissue measure (6×3×2)cm cut section reveled 3 lymph nodes matted together have white firm cut surfaces multiple piece taken for in 3 cassette
Extra pulmonary TB including lymphadenopathy TB being more common, tuberculous lymphadenopathy Axillary tuberculous lymphadenopathy is rare, presents a problem of differential diagnosis with breast carcinoma, and has a major prevalence between 20-50 years old, which was in keeping with our patient aged 45 years [7]

Summary

Introduction

Extra pulmonary TB accounts for about 7-30% of TB cases and lymphadenitis accounts for 17-43% of cases. Tuberculous lymphadenitis presents as a painless, slowly progressive swelling of a single group of nodes and in 85% of cases involvement is unilateral [5]. It may resemble breast carcinoma or exist both at the same time resulting in diagnostic and therapeutic challenges [1, 6]. The infection may spread from primary focus to regional lymph nodes. Mediastinal and paratracheal lymphnodes are the first site of spread of infection from the lymphatic drainage routes for the lung parenchyma. [8] Cervical tuberculous lymphadenitis may represent a spread from the primary focus of infection in the tonsils. Mediastinal and paratracheal lymphnodes are the first site of spread of infection from the lymphatic drainage routes for the lung parenchyma. [8] Cervical tuberculous lymphadenitis may represent a spread from the primary focus of infection in the tonsils. [9, 10] Axillary tuberculous lymphadenitis is rare and has major prevalence between 20 and 50 years old

Case Report

Findings

Discussion

Conclusions