Tuberculous Lymphadenopathy in Adults: A Review of 35 Cases

• Main Authors: Ali MERT, Fehmi TABAK, Reşat ÖZARAS, Recep ÖZTÜRK, Hilal AKI, Yıldırım AKTUĞLU
• Format: Article
• Language: English
• Published: Bilimsel Tip Yayinevi 2001-09-01
• Series: Flora Infeksiyon Hastalıkları ve Klinik Mikrobiyoloji Dergisi
• Subjects: Tuberculosis; Lymphadenopathy; Granuloma; Polymerase chain reaction
• Online Access: http://www.floradergisi.org/getFileContent.aspx?op=REDPDF&file_name=2001-6-3-201-205.pdf

We followed-up 35 cases (25 female, 10 male, mean age: 33 ± 17 years, range: 16-70) of tuberculous lymphadenopathy (TB LAP) between 1981-2000. We reviewed clinical, radiographic, and laboratory, results as well as diagnostic, therapeutic and prognostic features of the patients retrospectively. The diagnosis of TB LAP was established by the confirmation of tissue histology (in 32), or by the presence of acid-fast bacilli (AFB) in aspirate (in 2) or in sinus drainage (in 1). Paraffin-embedded tissues of granulomatous adenitis were studied for Mycobacterium tuberculosis DNA by polymerase chain reaction (n= 21). During admission, 34% of the patients had enlarging LAP, 9% had draining LAP, and 57% had both enlarging LAP and systemic complaints. The cervical lymph nodes were most frequently involved (77%). Erythrocyte sedimentation rate (ESR) was > 100 mm/hour in 25% of the cases and all of these cases were associated with systemic complaints. Tuberculin skin test was positive in 91% of the cases. AFB could not be seen in granulomas studied (0/21), PCR yielded positive result in 33% (7/21). All the patients were prescribed anti-TB treatment (isoniazid, rifampin, ethambutol, and/or pyrazinamide). Two patients needed surgical excision for their draining lymph nodes in addition to the medical therapy. Clinical improvement was obtained within 3 months, and ESR returned to normal within 5 months. Twenty two patients hod been followed-up for 3 years following the treatment and recurrence was not observed in any. In conclusion, TB LAP is generally presented with painless, small, few and slowly growing lymph nodes. The exact diagnosis should be based on tissue sampling. Anti-TB drugs are essential for the treatment.