Tuberculous cervical lymphadenopathy: should antituberculous therapy be preceded by histological proof?
In this retrospective study, 212 patients with cervical lymphadenopathy (CL) were studied over a 4-year period (1987-1990). Ninety-six (45.3%) were found to be tuberculous, 64 (30.2%) had reactive hyperplasia, 31 (14.6%) had a malignant lymphoma, 12 (5.7%) showed metastatic carcinoma and nine (4.2%) were due to miscellaneous causes. The original provisional diagnosis was incorrect in 20 cases who were later found to have tuberculous lymphadenopathy (TL) and in 12 patients with secondary malignancy who were originally diagnosed as tuberculous. The study shows that treatment should be preceded by histological proof to avoid delay in treatment of serious malignant disorders, to avoid unnecessary antituberculous treatment in patients with benign reactive lymphadenopathy and to prevent delay of antituberculous treatment in tuberculous patients with atypical clinical presentations.
Morad
N A
NA
Department of Pathology, College of Medicine, King Saud University, Saudi Arabia.
D000328:Adult; D017677:Age Distribution; D000995:Antitubercular Agents / Q000627:therapeutic use*; D001706:Biopsy; D003951:Diagnostic Errors / Q000517:prevention & control / Q000706:statistics & numerical data*; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology / Q000556:secondary; D006801:Humans; D008199:Lymphadenitis / Q000473:pathology; D008223:Lymphoma / Q000473:pathology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012529:Saudi Arabia / Q000453:epidemiology; D017678:Sex Distribution; D014388:Tuberculosis, Lymph Node / Q000188:drug therapy* / Q000453:epidemiology / Q000473:pathology*; D019564:Unnecessary Procedures / Q000706:statistics & numerical data*
D000995:Antitubercular Agents