title: Factors that make it difficult to diagnose cervical tuberculous lymphadenitis.
abstract: Cervical tuberculous lymphadenitis is mainly diagnosed by analyzing tissue samples obtained by fine-needle aspiration (FNA). However, some cases remain diagnostic challenges even after polymerase chain reaction analysis of FNA specimens. To delineate differences between cases that are relatively easy to diagnose and those for which diagnosis is difficult, 22 patients with cervical tuberculous lymphadenitis were studied retrospectively. FNA tissues were used to diagnose 14 cases (group A), whereas excisional biopsy was required for accurate diagnosis of 8 cases (group B). These two groups were compared with regard to results of blood examinations, ultrasound appearance, and various other procedures required to reach the final diagnosis. The results indicated that diagnosis of cervical tuberculous lymphadenitis was more difficult for patients with lower white blood cell counts, lower serum C-reactive protein levels, and absence of lymph node fusion or abscess formation on ultrasonography. The possibility of tuberculosis as a cause of cervical lymphadenopathy should always be considered, even when the presenting symptoms are not typical of this disease.
authors.affiliation: Department of Otolaryngology, Himeji Red Cross Hospital, 12-1 Shimoteno 1-Chome, Himeji, Hyogo, 670-8540, Japan, tomoyasutachibana@hotmail.co.jp.
authors.forename: Tomoyasu
authors.initials: T
authors.lastname: Tachibana
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Orita
authors.forename: Masayoshi
authors.initials: M
authors.lastname: Fujisawa
authors.forename: Michihiro
authors.initials: M
authors.lastname: Nakada
authors.forename: Yuya
authors.initials: Y
authors.lastname: Ogawara
authors.forename: Yuko
authors.initials: Y
authors.lastname: Matsuyama
authors.forename: Iku
authors.initials: I
authors.lastname: Abe
authors.forename: Yasuharu
authors.initials: Y
authors.lastname: Sato
authors.forename: Koichi
authors.initials: K
authors.lastname: Uesaka
authors.forename: Kazunori
authors.initials: K
authors.lastname: Nishizaki
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000473:pathology; D014463:Ultrasonography; D055815:Young Adult