Clinical analysis of 21 cases of cervical tuberculous lymphadenitis without active pulmonary lesion.
CONCLUSIONS
The necessity of considering cervical tuberculous lymphadenitis (CTL) should be emphasized even today for the differential diagnosis of cervical lymphadenopathy, particularly when it is located in the posterior triangle and supraclavicular regions even in patients without active pulmonary tuberculosis (PTB).


OBJECTIVE
This study was conducted to highlight the characteristics of patients with CTL without active PTB who were treated in our department.


METHODS
Between 2004 and 2011, 21 cases of CTL without active PTB were included in this retrospective study. Histological examination after excisional biopsy of the affected lymph node was performed in 18 patients using hematoxylin and eosin staining and Ziehl-Neelsen (Z-N) staining for acid-fast bacilli (AFB) identification. Growth of Mycobacterium tuberculosis was detected by culturing and/or nucleic acid amplification tests including polymerase chain reaction (PCR) and transcription-mediated amplification (Mycobacterium Tuberculosis Direct: MTD).


RESULTS
The male to female ratio was 1:1.3. Patient ages ranged from 22 to 89 years. Eighteen patients (85.7%) complained of indolent unilateral cervical lymphadenopathy in the posterior triangle (26.5%), internal jugular (24.5%), or supraclavicular nodes (18.4%). Positive rates of AFB according to Z-N staining and culturing of M. tuberculosis and/or PCR or MTD were 33.3% (6/18) and 72.2% (13/18), respectively.
Department of Otolaryngology and Head & Neck Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan. h-iguchi@med.osaka-cu.ac.jp
Hiroyoshi
H
Iguchi
Tadashi
T
Wada
Naoki
N
Matsushita
Yuichi
Y
Teranishi
Hideo
H
Yamane
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D014388:Tuberculosis, Lymph Node / Q000453:epidemiology*; D014397:Tuberculosis, Pulmonary / Q000473:pathology; D055815:Young Adult