Cervical lymphadenopathy: scrofula revisited

2008 ◽  
Vol 123 (7) ◽  
pp. 764-767 ◽  
Author(s):  
R Khan ◽  
S H Harris ◽  
A K Verma ◽  
A Syed

AbstractBackground:The commonest form of extrapulmonary tuberculosis is tubercular cervical lymphadenitis, or scrofula.Methods and results:A total of 1827 patients with cervical lymphadenopathy who presented to various out-patients clinics of our institution were studied over a three-year period. Eight hundred and ninety-three (48.87 per cent) of these patients had lesions of tubercular origin. The most common observation was unilateral, matted adenopathy in female patients aged between 11 and 20 years and without constitutional symptoms of tuberculosis. Posterior triangle nodes were affected in 43.8 per cent of cases, followed by upper deep cervical nodes in 33.9 per cent. Fine needle aspiration cytology constituted the main diagnostic tool, with a positive yield in 90 per cent of patients. Polymerase chain reaction analysis was performed in 126 patients, with a sensitivity of 63 per cent. Only 18 per cent of patients had associated pulmonary tuberculosis, the rest having isolated involvement of cervical nodes. Medical treatment with anti-tubercular drugs for a period of six months formed the mainstay of treatment and cure. Surgical management was reserved for selected refractory patients.Conclusion:Tubercular cervical lymphadenitis can readily be diagnosed by fine needle aspiration cytology, a simple and cost-effective test. The disease can be cured completely by a short course of anti-tubercular chemotherapy, without surgical intervention.

Author(s):  
Nitin Sharma ◽  
Maya Singh ◽  
Pritosh Sharma ◽  
Rahul Nahar ◽  
V. P. Goyal

<p class="abstract"><strong>Background:</strong> Cervical lymphadenopathy is the sign of a disease process which involves lymph nodes that are anomalous in uniformity and dimensions. It is very vital to exercise fine-needle aspiration biopsy, histopathological investigation, and ultrasonography for the diagnosis of palpable lesions.</p><p class="abstract"><strong>Methods:</strong> This is a prospective study of 12-month duration from January 2018 to December 2018 in 61 patients presenting with cervical lymphadenopathy admitted in the ENT Department at Geetanjali Medical College and Hospital, Udaipur.  </p><p class="abstract"><strong>Results:</strong> In biopsy, most common diagnosis was chronic granulomatous lymphadenitis i.e. in 62.3% of the patients. As compared to biopsy, fine-needle aspiration cytology (FNAC) showed chronic granulomatous lymphadenitis in 46% of the patients, with overall sensitivity of 91.1%, and specificity of 60.0%. and accuracy of 88.5%. Whereas ultrasonography (USG) reported, 64% cervical lymphadenopathy in patients, with overall sensitivity came out to be 91.1%, specificity to be 40.0%, accuracy was 86.9%.</p><p class="abstract"><strong>Conclusions:</strong> Present study showed that biopsy is the gold standard procedure for diagnosis of cervical lymphadenopathy lesions followed by FNAC, USG. Tuberculous lymphadenitis was most common diagnosis made by the diagnostic modalities.</p>


1970 ◽  
Vol 7 (1) ◽  
pp. 1-5 ◽  
Author(s):  
G Shakya ◽  
S Malla ◽  
KN Shakya ◽  
R Shrestha

Background: Fine Needle Aspiration Cytology (FNAC) is a reliable and least expensive method suitable for developing countries like Nepal for the investigation of lymphadenopathy. Knowledge about the pattern of lymphadenopathy is useful in pathological reporting as well as in many clinical settings with diagnostic dilemma. This is a baseline study to investigate the pattern of cervical lymphadenopathy by lymph node FNAC in Nepalese population. Methods: A retrospective study was conducted by critically analyzing the case reports on cervical lymph node FNAC from three years' records (July 2005 to June 2008) at the National Public Health Laboratory, Teku, Kathmandu. Review of all cytological reports were done according to standard guidelines and the diagnosis was classified and correlated with patients' age and ethnicity to explore the pattern and association. Results: Of 508 cervical lymph node FNAC cases, 50.4% was reactive non-specific, 22.4% was tubercular, 4.8 % malignant, 10% chronic granulomatous and the remaining was acute suppurative (12.4%). Highest incidence of malignancy was seen in the fifth decade (50%). Whereas, tubercular lymphadenopathy was found with increasing frequency through childhood (10.5%) and adolescence (21.7%) to young adulthood (30.4%), probably indicative of waning immunity of BCG vaccination. Ethnic groups comprising of Tamang, Sherpa and Bhote had the highest incidence of malignant as well as tubercular lymphadenopathy. Conclusion: The relationship of malignant and tubercular lymphadenopthy with age and ethnicity deserves further study. Efforts at preventing tubercular and early diagnosing malignant lymphadenopathy and reducing morbidity in general will find great usefulness in such associations. Key words: Cervical Lymphadenopathy, Fine Needle Aspiration Cytology, Pattern   DOI: 10.3126/jnhrc.v7i1.2267 Journal of Nepal Health Research Council Vol. 7, No. 1, 2009 April 1-5


1970 ◽  
Vol 1 (2) ◽  
pp. 12-13 ◽  
Author(s):  
D Shrestha ◽  
P Thapa ◽  
M Dahal

Keywords: Tubercular cervixal lymphadenitis; fine needle aspiration cytology; biopsy; histopathological examiniationDOI: 10.3126/njenthns.v1i2.4757 Nepalese J ENT Head Neck Surg Vol.1 No.2 (2010) p.12-13


2012 ◽  
Vol 2012 ◽  
pp. 1-3 ◽  
Author(s):  
Meher Aziz ◽  
Prasenjit Sen Ray ◽  
Nazima Haider ◽  
Sumit Prakash Rathore

Rosai-Dorfman disease (RDD) is a rare benign disorder of histiocytic proliferation that usually presents with bilateral cervical lymphadenopathy in children. We describe the case of a 50-year-old lady suffering from this disease who presented with generalized lymphadenopathy and a left sided chest wall lump. Fine needle aspiration cytology (FNAC) from all the lesions showed abundant benign histiocytes with lymphophagocytosis which was compatible with the diagnosis of RDD. This case is being reported for its rarity in presentation in an elderly female with both generalized nodal as well as extranodal manifestations.


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