title: Epidemiology and diagnosis of tuberculous lymphadenitis in a tuberculosis low-burden country.
abstract: The aim of this article is to describe epidemiological and clinical data of patients with tuberculous lymphadenitis (TL) and evaluate the yield of the diagnostic techniques employed. Retrospective observational study was performed at the Vall d'Hebron University Hospital, Barcelona, Spain. All adult patients with confirmed TL (microbiologically) or probable TL (suspected by clinical presentation, cyto/histopathological features, and clinical improvement after specific treatment) diagnosed from January 2001 to December 2013 were included. One hundred twenty-two patients were included: 78 (63.9%) patients with confirmed diagnosis and 44 (36.1%) patients with probable TL. Seventy (57.4%) patients were nonnative residents. From 83 fine-needle aspiration (FNA) specimens, 54.8% (40/73) showed granulomatous inflammation, 62.5% (40/64) had positive mycobacterial culture, and 73.3% (11/15) tested positive with Xpert MTB/RIF (Cepheid, Sunnyvale, CA). From 62 biopsy samples, 96.8% (60/62) showed granulomatous inflammation, 64.6% (31/48) had positive mycobacterial culture, and 46.1% (6/13) tested positive with Xpert MTB/RIF. TL has increasingly been diagnosed in our setting, mostly because of cases diagnosed in nonnative residents. FNA is an easy and safe technique for the diagnosis of suspected TL, and the yield regarding mycobacterial culture seems to be similar to the obtained with biopsy. The Xpert MTB/RIF test from FNA specimens may increase the accuracy of the TL diagnosis and provides quicker results.
authors: From the Department of Infectious Diseases (FS, IL-A, AS-M, AC, NS, IM), Vall d'Hebron University Hospital, Universitat Autònoma de Barcelona, PROSICS Barcelona; Department of Microbiology (TT), Vall d'Hebron University Hospital; Department of Pneumology (AV); and Department of Pathology (JC), Vall d'Hebron University Hospital, Barcelona, Spain.
authors: Fernando
authors: F
authors: Salvador
authors: Ibai
authors: I
authors: Los-Arcos
authors: Adrián
authors: A
authors: Sánchez-Montalvá
authors: Teresa
authors: T
authors: Tórtola
authors: Adrian
authors: A
authors: Curran
authors: Ana
authors: A
authors: Villar
authors: Nuria
authors: N
authors: Saborit
authors: Josep
authors: J
authors: Castellví
authors: Israel
authors: I
authors: Molina
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044963:Biopsy, Fine-Needle; D005260:Female; D006099:Granuloma / Q000473:pathology; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009169:Mycobacterium tuberculosis / Q000235:genetics / Q000302:isolation & purification; D016133:Polymerase Chain Reaction; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D013030:Spain / Q000453:epidemiology; D014388:Tuberculosis, Lymph Node / Q000175:diagnosis* / Q000453:epidemiology*; D055815:Young Adult
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