“Tuberculous and Nontuberculous Cervical Lymphadenitis: A Clinical Experience”

Abstract

Introduction: Tuberculosis is one of the leading causes of death in adults. Tuberculous lymphadenitis continues to be a major health problem in our country. In patient with cervical lump, tuberculosis remains a common cause. Tuberculous cervical lymphadenitis is commonly encountered in clinical practice. Objective: To observe whether there are any differences in clinical characteristic between tuberculous and nontuberculous lymphadenitis and to evaluate the importance of fine needle aspiration cytology (FNAC) in the management of tuberculous cervical lymphadenitis. Materials & Methods: A prospective study was carried out among 101 patients of cervical lymphadenitis in ENT department of Mission General Hospital, Nilphamary, Bangladesh. The study period was from June 2019 to June 2019. Results: There were 53 male and 48 female. The age ranged from 9 to 68 years. Posterior triangles were found to be the most common involved site. The incidences of constitutional symptoms, like malaise, anorexia, weight loss and fever were similar between the two groups. Thirty nine patients were diagnosed as tuberculous lymphadenitis by FNAC, 53 patients diagnosed as reactive lymphadenitis and no definitive diagnosis were made for 8 patients. The excisional biopsy reported 42 patients as tuberculous lymphadenitis, 56 were diagnosed as reactive lymphadenitis and two patients were diagnosed as Non-Hodgkin’s Lymphoma. In this study sensitivity and specificity of FNAC in the diagnosis of the tuberculous lymphadenitis were 85.71% and 94.82% respectively. Conclusion: Patients with tuberculous and non-tuberculous lymphadenitis had similar clinical features and hence were difficult to differentiate clinically. FNAC is a highly specific tool in the diagnosis of tuberculous lymphadenitis.