• Title/Summary/Keyword: Tuberculous cervical lymphadenitis

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Clinical Manifestations and Therapy of Tuberculous Cervical Lymphadenitis (경부 결핵성 림프절염의 임상양상과 치료)

  • 김상현;황동조;문준환;김정수
    • Korean Journal of Bronchoesophagology
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    • v.5 no.1
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    • pp.7-13
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    • 1999
  • Background and Objective: The tuberculous lymphadenitis of neck is one of the most common extra-pulmonary tuberculosis in Korea. Although the incidence of pulmonary tuberculo-sis has decreased recently, that of cervical tuberculous lymphadenitis has not decreased. In spite of great efforts and diversity of study, the exact criterias of diagnosis and optimal therapeutic methods of cervical tuberculous lymphadenitis have been the subject of much debate and still remain unclear. So we intend to enucleate clinical manifestations and suggest the optimal therapeutic manners. Material : The 483 cases, diagnosed as cervical tuberculous lymphadenitis by fine needle aspiration biopsy during the past 10 years from Jan. 1987 to Dec. 1996 Method : Retrospective study Results 1) The overall rate of tuberculous cervical lymphadenitis was 23.4% of neck mass. 2) Incidence ratio of male to female was 1:2.7 3) The frequent location of tuberculous lymphadenitis was posterior cervical area, supraclavicular area, jugular chain in order. 4) The response rate of medical treatment in tuberculous cervical lymphadenitis was 84.9%. 5) The duration of medical treatment in remissioned group was 18.6 months in average. 6) Surgical intervention was needed in 15.1%. 7) The duration of post operative medical treatment was 18.4 months in average. Conclusion : Tuberculous cervical lymphadenitis is prevalent in women, age of 20-40 years and mainly involve posterior cervical area. Fine needle aspiration biopsy is a very useful method for early detection of cervical tuberculous lymphadenitis. After diagnosis is made, anti-tuberculosis medication is recommended for more than 18 months. Unless the size of neck mass is decreases inspite of the thorough anti-tuberculosis medication for more than 1 month or if complication like as abscess or fistula occurs, surgery is needed with post operative medical treatment for more than 12 months.

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The Treatment Result of Antituberculous Chemotherapy Followed by Surgical Excisions in Tuberculous Cervical Lymphadenitis (경부 결핵성 림프절염에서 외과적 절제수술후 항결핵제 요법시의 치료 성적)

  • Park Dong-Enn;Kim Sang-Hyo
    • Korean Journal of Head & Neck Oncology
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    • v.18 no.2
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    • pp.192-196
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    • 2002
  • Objectives: Tuberculous cervical lymphadenitis is a frequently recurring disease when treated with chemotherapy alone without enough surgical removal of the tuberculous lesions. Authors reviewed retrospectively the treatment result of antituberculous chemotherapy following almost complete surgical removal of tuberculous foci in the neck. Materials and Methods: A retrospective clinical review and analysis was made in 127 cases of tuberculous cervical lymphadenitis patients treated during the past 10 years from 1989 to 1998 at the Department of General Surgery, Inje University Paik Hospital, Pusan. Results: 1) The peak age incidence was the 2nd decade(37.8%), and female was predominated over male by 2.3:1. 2) The time interval from the onset of symptoms to the first visit was less than 3 months in 60.6% of the patient. 3) The location of lymphadenitis was the right neck in 60%, the left neck 34%, and bilateral in 6% of the patient. 4) Signs on the first visit showed solitary masses(60%), abscess(25%) and both mixed(15%). 5) 25 patients(19%) had present or past history of tuberculosis; pulmonary tuberculosis 12 patients, tuberculous lymphadenitis 10 patients, and others 3 patients. 6) Locations of tuberculous lymphadenitis were posterior cervical triangle 70, supraclavicular 51, submandibular 19, anterior triangle 16 and others 4 cases. 7) The principle of treatment of cervical lymphadenitis was surgical management followed by chemotherapy. Surgical procedures were excision(s), curettage and drainage of abscess, combination of both, and biopsy in 60%, 22%, 12% and 6% respectively. Mean duration of antituberculous medication was 9 months after surgery. 8) The rate of recurrent and persistent tuberculous lymphadenitis was 9% in 4 years follow up. Conclusion: Tuberculous cervical lymphadenitis is a frequently recurring disease in young adult when only antituberculous chemotherapy was employed without almost complete removal of the lesions. It is considered that antituberculous medications for 6-9 months after removing the foci at a maximal extent by surgical excision and curettage will reduce the recurrence rate or persistence of tuberculous lymphadenitis.

Tuberculous Cervical Lymphadenitis (경부 결핵성 임파선염)

  • Kim Joong-Kyu;Lee Choong-Han
    • Korean Journal of Head & Neck Oncology
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    • v.11 no.1
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    • pp.3-8
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    • 1995
  • Tuberculous cervical lymphadenitis is one of common cause of neck mass in young adult in Korea. Tuberculous cervical lymphadenitis known as scrofula was being treated by the 'Royal Touch' in the 5th century and by surgery in the 17th century, yet the principle of the treatment is still controversal. We report the clinical evaluation and therapeutic result about 121 tuberculous cervical lymphadenitis. The result were as follows: 1) The annual incidence(1985-1994) was 30.5 % (37 cases: 1985-1986), 17.7 % (21 cases: 1990-1992). 19.8%(24 cases: 1994). 2) The age of highest incidence was 20-29 year old age group in 41.3% (50 cases) and female predominated over male by 1.8 : 1. 3) The duration of disease was less than 6 months, in 85.9% (104 cases). 4) The most commonly involved LN group was superficial cervical group in 69.4% (84 cases), and difference between Rt & Lt, was not significant. 5) The most common symptom and local finding(P/E) were, painless swelling of LN in 74.3 % (90 cases) and single mass in 59.5 % (72 cases). 6) In seasonal variation, 85.9% (104 cases) was spring and summer. 7) Procedures except biopsy for evaluation were chest PA, AFB smear & culture(sputum), Mantoux test, USG, CT and, Associated extracervical tuberculous lesions were lung, axilla, breast. 8) In operation method (involving biopsy), Excision was 68.5 % (83 cases), neck dissection was 6.6% (8 cases). 9) The Modality, Duration and side effect of antituberculous medication: INH-Rifampin­Ethambutol was 66.1 % (88 cases), duration was 1 year in 84.3% (102 cases), side effects were severe GI trouble (24.8%), liver function damage (3.3%). 10) 3 cases recurred on the same site after 2 yrs(2 cases) and 4 months(1 case) and its treatment was curretage or I & D, with antituberculous medication.

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Diagnosis of Cervical Tuberculous Lymphadenitis with Fine Needle Aspiration Biopsy Under Ultrasonographic Guides (초음파 유도하 세침 흡인 생검을 이용한 경부 결핵성 림프절염의 진단)

  • Suh Kwang-Wook;Park Cheong-Soo;Lee Jong-Tae;Lee Kwang-Gil
    • Korean Journal of Head & Neck Oncology
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    • v.8 no.2
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    • pp.91-96
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    • 1992
  • The efficacy of the fine needle aspiration biopsy and cytological examination(FNABC) under ultrasonographic(US) guides for the diagnosis of cervical tuberculous lymphadenitis was assessed. There were one hundred and one patients whose neck masses were proven to be tuberculous lymphadenites with cytologic and/or histologic diagnosis. The physical characteristics shown by US revealed that all the cases were multiple lesions. Multiregional lesions were found in 80 cases(79.1%) and 19 cases(18.8%) were the bilateral lesion. The region V was the most prevalent site(n=69, 68.3%). US findings revealed 92 cases(90.9%) showed hypoechoic lesions and 9(9.1%) showed mixed echo patterns. There was no hyperechoic lesion (p<0.05). The sensitivity of FNABC was 77.2% and specificity was 99.0%. Diagnostic accuracy was 85.0%. There was no complication during the procedures. FNABC for the diagnosis of cervical tuberculous lymphadenitis is a safe, convinient procedure and has a high specificity. The pitfall of FNABC the low sensitivity, seemed to be compensated by US evaluations.

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Diagnosis of Tuberculous Cervical Lymphadenitis Using Polymerase Chain Reaction (경부 임파절에서 Polymerase Chain Reaction(PCR)을 이용한 결핵균의 진단에 관한 연구)

  • Kim, Ho-Joong;Hyun, In-Kyu;Lee, Myoung-Koo;Jung, Ki-Suck;Ahn, Hye-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.1
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    • pp.35-41
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    • 1995
  • Background: Tuberculous cervical lymphadenitis can be diagnosed by clinical findings, chest X-ray, Mantoux test, but confirmed only by excisional biopsy. The polymerase chain reaction(PCR) is now widely applied to test very small amount of pathogen and would be used to detect Mycobacterium tuberculosis in biopsied tissues and fine needle aspirates. Method: We carried out the PCR using IS-1 and IS-2 primers in 16 samples from tuberculous cervical lymphadenitis patients, and 13 samples from non-tuberculous cervical lymphadenopathy patients. Acid fast staining and culture for Mycobacterium were all negative. Results: All of 8 pathologically confirmed tuberculous cervical lymphadenitis samples showed positive PCR results, and of 5/8 clinically diagnosed samples were positive. None of 6 pathologically excluded samples were positive, and among 7 clinically undiagnosed samples 2 showed positive PCR results. Conclusion: In patients with suspected tuberculous cervical lymphadenitis, PCR could be used to detect Mycobacterium tuberculosis using biopsied tissues and even fine needle aspirates with good sensitivity and specificity.

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A Case Report of Isolated Inguinal Tuberculous Lymphadenitis (서혜부 단독 결핵성 림프염의 증례보고)

  • Koo, Hyun-Kook;Kim, Young-Seok;Kim, Min-Joo;Roh, Tai-Suk;Rah, Dong-Kwun
    • Archives of Plastic Surgery
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    • v.37 no.5
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    • pp.705-707
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    • 2010
  • Purpose: Tuberculous lymphadenitis constitutes about 30% of all types of extrapulmonary tuberculosis. Cervical lymphadenitis is the commonest form (70%), followed by axillary and inguinal. But inguinal tuberculous lymphadenitis is rare form. Especially isolated inguinal tuberculous lymphadenitis was seldom reported. In Korea, that case was not reported. This case emphasizes the need for awareness of tuberculosis as a possible cause of isolated inguinal adenitis. Methods: We experienced one case of isolated inguinal tuberculous lymphadenitis. We analyzed clinical features, preoperative assessments and method of treatments. Results: A 37-year-old female patient presented with a painless swelling in the left inguinal region of 12 month's duration. There was no history of urethral discharge, dysuria, genital sores, unprotected sexual contacts or trauma. Examination revealed enlarged left inguinal lymph nodes, $2{\times}1\;cm$, non-tender and firm mass. The external iliac, popliteal, right inguinal and other groups of lymph nodes were normal. Serologic tests, urinary tests and chest radiologic test were normal. The excision of mass was performed under the general anesthesia. A excisional biopsy showed chronic granulomatous inflammation with caseous necrosis, consistent with tuberculosis. After excision, the primary repair was done and completely healed on postoperative 25 days. Conclusion: The isolated inguinal tuberculous lymphadenitis was rare form of inguinal suppurative mass. Although medical management is the principal mode of therapy of tuberculous adenitis and surgery is rarely necessary, we didn't consider the possibility of tuberculous lymphadenitis in our case. A high index of suspicion is essential for a diagnosis of isolated inguinal tuberculous lymphadenitis. Our case emphasizes this importance and illustrates the need for awareness of tuberculosis as a possible cause of isolated inguinal adenitis.

Polymerase Chain Reaction Detection of Mycobacterium tuberculosis and Fine Needle Aspiration Cytology for the Diagnosis of Tuberculous Lymphadenitis (결핵성 림프절염의 진단를 위한 세침흡인 세포검사 및 중합효소연쇄 반응과 효소면역법을 이용한 Mycobacterium tuberculosis의 검출)

  • Kim, Joo-Heon;Kim, Nam-Hoon;Kang, Dong-Wook;Park, Mee-Ja;Moon, Sang-Kyoung;Yu, Tae-Cho;Jang, Eun-Ju
    • The Korean Journal of Cytopathology
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    • v.12 no.1
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    • pp.25-30
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    • 2001
  • Tuberculous lymphadenitis is not uncommon in Korea. Therefore, an inexpensive, safe and rapid method is needed to diagnose the tuberculous lymphadenitis. Flne needle aspiration cytology Is a good method for this purpose, but has several limitations in the diagnosis of tuberculous lymphadenitis, especially when the presence of acid-fast bacilli is not proved. To evaluation the usefulness of the polymerase chain reaction with enzyme immunoassay technique in the detection of Mycobacterium tuberculosis (M. tuberculosis) In the cervical Iymph node asplrates, the authors performed fine needle aspiration cytology and M. tuberculosis PCR with enzyme immunoassay for mycobacterial DNA sequences from 15 cases of the fine needle aspirates. Cytomorphologically, the cases were categorized into three types: predominantly necrotic materials; typical epithelioid cell granulomas with or without slant cells and caseous necrosis; and non-tuberculous lesions, such as reactive lymphadenitis, abscess, metastatic carcinoma and malignant lymphoma. M. tuberculosis DNA was found in 8 of 15 cases by PCR with enzyme immunoassay. Negative findings on PCR were achieved in 7 cases, which revealed non-tuberculous tymphadenopathy. In conclusion, we suggest that M. tuberculosis PCR with enzyme immunoassay using the fine needle aspirates is a very useful tool for the diagnosis of tuberculous lymphadenitis.

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A case of single cervical tuberculous cold abscess associated with multi-loculated tuberculous pleurisy. (다발성 소방이 형성된 결핵생 흉막염 환자에서 경부에 결핵성 단일 한성농양을 보인 1예)

  • Lee, Jeong-Aa;Kim, Eui-Sook;Baek, Young-Joo;Lee, Gwang-Seob;SunWoo, In-Cheol;Kim, Dae-Ha;Jang, Jie-Jeong;Park, Suck-Min;Ji, Mi-Kyung
    • Tuberculosis and Respiratory Diseases
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    • v.43 no.3
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    • pp.434-439
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    • 1996
  • Although the incidence of pulmonary tuberculosis is declining, the number of extrapulmonary tuberculosis has remained constant. Tuberculous Lymphadenitis accounts for over 50% of total inflammatory lymphadenitis and the most common site is cervical lymph node. We report a case of single cervical tuberculous cold abscess associated with multiloculated and septated tuberculous pleurisy. Intracavitary urokinase instillation via percutaneous catheter is indicated in loculated and septated pleural effusion. And our result was satisfactory without complication.

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Clinical analysis of tuberculous cervical lymphadenitis (경부 결핵성 임파선염의 임상적 고찰)

  • 김영민;송병찬;윤성철;박영민
    • Proceedings of the KOR-BRONCHOESO Conference
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    • 1993.05a
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    • pp.107-107
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    • 1993
  • Tuberculous cervical lymphadenitis is one of the most common causes of neck mass in Korea. But the diagnostic confirmation is difficult and it's effective treatment modalities are still in controversy. Through a retrospective study of 32 cases of tuberculous cervical lymphadenitis treated with surgical treatment during recent 4 years, we have analyzed 5 subtypes of CT finding and surgical treatment modalities and received following results 1. The locations of lymphadenitis were posterior triangle(12 cases), submandibular area(9 cases), supraclavicular area(8 cases), submental area(2 cases), and parotid area(1 case). 2. Five subtypes of CT findings were observed : Homogeneous enhancement type(3 cases), peripheral rim enhancement type(6 cases), peripheral rim enhancement with perinodal fat obliteration type(12 cases), coalescent cold abscess type(8 cases), and mixed type(3 cases). 3. Surgical treatment modalities : Excision (13 cases), incision and drainage(9 cases), selective neck dissection(8 cases), and curettage(2 cases).

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