• 대한기관식도과학회지
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• 제5권1호
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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.

• 대한두경부종양학회지
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• 제18권2호
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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.

• 대한두경부종양학회지
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• 제11권1호
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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.

• 대한두경부종양학회지
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• 제8권2호
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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.

• Tuberculosis and Respiratory Diseases
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• 제42권1호
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• pp.35-41
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• 1995

연구배경: 결핵성 경부임파선염의 진단은 임상소견, 흉부 X-선검사, 튜베르큘린검사의 비관혈적 방법으로 내리기 어려워, 경부 임파절 생검을 필요로 하는 경우가 많다. 저자들은 종합효소연쇄반응(polymerase chain reaction, PCR) 기법을 이용하여 결핵성 경부임파선염을 진단할 수 있는지 알아보고, 가능하다면 그 유용성을 평가해 보고자 본 연구를 시행하였다. 방법: 경부 종물로 내원한 환자의 생검 조직과 세침흡인 검체 29예에서 DNA를 추출하여, 결핵균 DNA인 IS6110의 일부를 복제하기 위한 IS-1,-2를 primer로 사용하여 PCR을 시행하였다. 결과는 임상적 진단 및 병리, 세균학적 진단과 비교하였다. 결과: 평균 107.5mg의 생검조직과 2회 세침흡인 검체에서 추출한 DNA의 양은 각각 평균 $32.46{\pm}17.22mg$과 $220{\pm}140ng$이었고 $OD_{260}/OD_{280}$은 각각 $2.11{\pm}0.23,\;2.76{\pm}0.39$이었으며, 상존유전자인 $\beta$-actin 유전자를 목표로 하는 PCR은 전예에서 양성이었다. 병리학적으로 결핵으로 진단한 8예중 8예 전예에서, 병리소견상 확진되지 않았으나 임상적으로 결핵성 경부임파선염으로 진단한 8예중 5예에서, 병리학적으로 악성 임파절전이나 갑상선낭종으로 진단되어 결핵성 경부임파선염이 배제된 6예중 0예에서, 그리고 임상적으로 결핵성 경부임파선염이 배제된 7예중 2예에서, 결핵균 DNA를 목표로 한 PCR 결과가 양성이었다. 결론: 경부 임파절 조직과 세침흡인 검체의 결핵균 PCR 기법은 결핵성 경부임파선염의 진단에 유용한 방법이라고 생각한다.

• Archives of Plastic Surgery
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• 제37권5호
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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.

• 대한세포병리학회지
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• 제12권1호
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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.

• Tuberculosis and Respiratory Diseases
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• 제43권3호
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• pp.434-439
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• 1996

저자들은 경부에 결핵성의 단일 한성농양을 보인 환자를 경험하였으며, 이 환자에서 결핵성 흉막염 치료시 소방형성으로 인해 흉수액의 배액이 안되었으나 도관을 통한 유로키나제의 주입으로 별다른 합병증없이 만족할만한 결과를 얻었기에 문헌고찰과 함께 보고하는 바이다.

• 대한치과의사협회지
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• 제25권2호통권213호
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• pp.106-106
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• 1987

• 대한기관식도과학회:학술대회논문집
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• 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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• pp.107-107
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• 1993

경부 결핵성 임파선염은 우리나라에서 경부 종괴의 흔한 원인중의 하나이다. 그러나 대부분 확진이 어려우며, 또한 효율적인 치료도 아직 논란이 많다. 저자들은 1989년 6월부터 1993년 2월까지 약 4년간 한림대학부속 강남성심병원에 경부종괴로 내원하여 수술적 치료를 시행하여 경부 결핵성 임파선염으로 확진되었던 32례에 대한 후향적 임상조사를 실시하여 경부 전산화단층촬영 소견을 5가지 유형으로 분류하였으며, 수술적 치료유형에 대한 고찰을 하여 다음과 같은 결과를 얻었다. 1. 종물의 위치는 후경부가 12례로 가장 많았으며 하악부 9례, 쇄골상부 8례, 이하부 2례, 이하선부 1례이었다. 2, 경부 전산화단층촬영 소견에 따라 다음의 5가지 형태로 분류할 수 있었다. : 균등조영 증강형 3례, 변연조영증강형 6례, 주변유착형 12례, 농양형 8례, 혼합형 3례. 3. 수술적 치료는 종물 절제술 13례, 절개 및 배농 9례, 선택적 경부청소술 8례, 소파술 2례를 시행하여 만족스러운 결과를 얻었다.