Tubercular cervical adenitis: clinicopathologic analysis of 180 cases.
OBJECTIVE
To analyze the clinical presentations, laboratory investigation results, and histopathologic evaluation of tubercular cervical adenitis (TCA) in our population.


METHODS
Prospective study.


METHODS
Tertiary health care centre.


METHODS
We studied 180 patients with TCA who were managed in the Department of Otolaryngology between December 2004 and June 2007.


RESULTS
There were 76 male patients (42%) and 104 females (58%), with ages ranging from 5 to 58 years. All patients presented with single or multiple neck swellings. Constitutional symptoms such as fever were present in 52 patients (29%), whereas cough, weight loss, and reduced appetite were seen in 40 patients (22%). Forty-seven patients (26%) had bilateral lymph node involvement. Only 23 patients (13%) had chest radiographs suggestive of pulmonary tuberculosis. Fine-needle aspirates from 168 patients (93%) showed granulomas with caseating necrosis. However, acid-fast bacilli were seen in only 45 (25%) aspirate smears. Twelve patents (7%) required a lymph node biopsy to confirm the diagnosis.


CONCLUSIONS
TCA usually presents with multiple lymph node involvement without the constitutional signs and symptoms of tuberculosis. The diagnosis is based on a high index of clinical suspicion coupled with laboratory and pathologic investigations.
Agarwal
A K
AK
Department of Otolaryngology and Head and Neck Surgery, Maulana Azad Medical College and associated L. N. Hospital, New Delhi, India.
Sethi
Ashwani
A
Sethi
Deepika
D
Malhotra
Vikas
V
Singal
Sukrati
S
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008199:Lymphadenitis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009333:Neck; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis*; D055815:Young Adult