TUBERCULOUS AND NONTUBERCULOUS CERVICAL LYMPHADENITIS: A CLINICAL REVIEW

Abstract

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 100 patients of cervical lymphadenitis in ENT department of National Academy of Medical Sciences, Bir Hospital, Kathmandu. The study period was from 15 June 2009 to 15 June 2010.

Results:

There were 52 male and 48 female. The age ranged from 9 to 63 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.

Keywords: biopsy, Fine needle aspiration cytology, histopathological examiniation, Tubercular cervixal lymphadenitis