Adjunctive Effects of Oral Steroids Along with Anti-Tuberculosis Drugs in the Management of Cervical Lymph Node Tuberculosis

Background: Tuberculosis (TB) can infect both pulmonary and extra-pulmonary organs. In India pulmonary TB accounts for 80% of cases and extrapulmonary TB (EPTB) accounts for 20% cases. Cervical lymph nodes are the most location for EPTB. Aims and Objectives: To study the efficacy of treatment with oral steroids along with anti-tuberculosis treatment in cervical lymph node tuberculosis. Methods: A total of 60 patients were enrolled in the study all with EPTB and cervical lymphadenitis. These 60 study patients were randomised into two groups. Group-I consisted of 30 patients given anti-tuberculosis therapy along with prednisolone 1mg/kg body weight for 4 weeks followed by tapering at 0.5 mg/kg body weight over 4 weeks. Group-II was comprised of 30 patients given antituberculosis treatment plus placebo Results: After completion of treatment 27 patients in Group I (90%) showed complete resolution and 3 patients (10%) had residual evidence of lymphadenitis with no change. In contrast, only 19 patients (63.3%) showed complete resolution in Group 2 and 11 patients (36.7%) had residual lymphadenitis present (10 had no change, 1 had increase in size). Conclusion: We conclude that steroids given with antituberculosis treatment to patients with cervical lymphadenitis led to faster and earlier resolution of tuberculous lymphadenitis.

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Role of Clinical Palpation in Evaluation of Cervical Lymph Node in Oral Squamous Cell Carcinoma

Update Dental College Journal ◽

10.3329/updcj.v1i2.13978 ◽

2013 ◽

Vol 1 (2) ◽

pp. 02-06

Author(s):

SM Anwar Sadat ◽

Sufia Nasrin Rita ◽

Shoma Banik ◽

Md Nazmul Hasan Khandker ◽

Md Mahfuz Hossain ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Oral Squamous Cell Carcinoma ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Squamous Cell ◽

Predictive Value ◽

Cervical Lymph Node ◽

Betel Quid ◽

Cervical Lymph Nodes

A cross sectional study of 29 cases of oral squamous cell carcinoma with or without cervical lymph node metastasis was done among Bangladeshi patients from January 2006 to December 2007. Majority of the study subjects (34.5%) belonged to the age group of 40-49 years. 58.6% of the study subjects were male, while remaining 41.4% of them were female. 51.7% of the lesions were located in the alveolar ridge where the other common sites were buccal mucosa (27.6%) and retro molar area (13.8%). Half of the study subjects (51.7%) were habituated to betel quid chewing followed by 37.9% and 10.3% were habituated to smoking and betel quid-smoking respectively. Grade I lesions was most prevalent (75.9%) in the study subjects. Majority of cases presented with Stage IV lesions (55.2%). The sensitivity, specificity, positive predictive value, negative predictive value & accuracy of clinical palpation method for determining metastatic cervical lymph nodes were 93.33%, 64.29%, 73.68%, 90% and 79.3% respectively. Careful and repeated clinical palpation plays important role in evaluation of cervical lymph nodes though several modern techniques may help additionally in the management of oral cancer.DOI: http://dx.doi.org/10.3329/updcj.v1i2.13978 Update Dent. Coll. j. 2011: 1(2): 02-06

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Cervical lymph node enlargement as the initial manifestation of rectal cancer

BMC Gastroenterology ◽

10.1186/s12876-021-01628-5 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tong-Hui Xie ◽

Peng Su ◽

Jian-Guo Hong ◽

Hui Zhang

Keyword(s):

Colorectal Cancer ◽

Rectal Cancer ◽

Lymph Node ◽

Lymph Nodes ◽

Cervical Lymph Node ◽

Clinical Manifestations ◽

Initial Symptom ◽

Cervical Lymph Nodes ◽

Supraclavicular Lymph Nodes ◽

Lymph Node Enlargement

Abstract Background Colorectal cancer is a very common malignant tumor worldwide. The clinical manifestations of advanced colorectal cancer include the changes in bowel habits, hematochezia, diarrhea, local abdominal pain and other symptoms. However, the colorectal cancer with an initial symptom of cervical lymph node enlargement is extremely rare. In this article, we report a case of rectal cancer presenting with cervical lymph nodes enlargement as the initial symptom. Case presentation A 57-year-old woman was admitted to our hospital for cervical lymph node enlargement which was accidentally detected during physical examination. Computed tomography scan revealed multiple enlarged lymph nodes in the neck. Cervical ultrasound showed normal thyroid gland and multiple left supraclavicular lymph nodes enlargement. The patient underwent lymph nodes biopsy and pathologic results showed metastatic adenocarcinoma. The subsequent lower gastrointestinal endoscopy revealed a mucosal bulge lesion located at rectus and biopsy revealed adenocarcinoma. The patient underwent rectal cancer resection. She is alive with no evidence of recurrence or new tumors 2 years after surgery. Conclusions Cervical lymph node metastasis is a rare metastatic way in colorectal cancer. This is the first case of rectal cancer presenting with cervical lymph nodes metastases as the initial symptom. Surgical resection combined with postoperative chemotherapy improved long-term prognosis of the patient. This rare metastatic way of rectal cancer should be paid attention for clinicians.

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A case of cervical lymph node tuberculosis and metastatic squamous cell carcinoma in the same lymph node

Respiratory Medicine Case Reports ◽

10.1016/j.rmcr.2021.101485 ◽

2021 ◽

pp. 101485

Author(s):

Yoshinori Uchida ◽

Shigeru Komatsu ◽

Takashi Ogura

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Cell Carcinoma ◽

Squamous Cell ◽

Cervical Lymph Node ◽

Metastatic Squamous Cell Carcinoma ◽

Lymph Node Tuberculosis

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Assessment of cervical lymph node metastases using indirect computed tomography lymphography with iopamidol in a tongue VX2 carcinoma model

The Journal of Laryngology & Otology ◽

10.1017/s0022215111000958 ◽

2011 ◽

Vol 125 (8) ◽

pp. 820-828 ◽

Cited By ~ 4

Author(s):

Y Shu ◽

X Xu ◽

Z Wang ◽

W Dai ◽

Y Zhang ◽

...

Keyword(s):

Computed Tomography ◽

Lymph Node ◽

Lymph Nodes ◽

Lymph Node Metastases ◽

Cervical Lymph Node ◽

Cervical Lymph Nodes ◽

Cervical Lymph Node Metastases ◽

Computed Tomography Images ◽

Vx2 Carcinoma ◽

Node Metastases

AbstractObjective:To investigate the performance of indirect computed tomography lymphography with iopamidol for detecting cervical lymph node metastases in a tongue VX2 carcinoma model.Materials and methods:A metastatic cervical lymph node model was created by implanting VX2 carcinoma suspension into the tongue submucosa of 21 rabbits. Computed tomography images were obtained 1, 3, 5, 10, 15 and 20 minutes after iopamidol injection, on days 11, 14, 21 (six rabbits each) and 28 (three rabbits) after carcinoma transplantation. Computed tomography lymphography was performed, and lymph node filling defects and enhancement characteristics evaluated.Results:Indirect computed tomography lymphography revealed bilateral enhancement of cervical lymph nodes in all animals, except for one animal imaged on day 28. There was significantly slower evacuation of contrast in metastatic than non-metastatic nodes. A total of 41 enhanced lymph nodes displayed an oval or round shape, or local filling defects. One lymph node with an oval shape was metastatic (one of 11, 9.1 per cent), while 21 nodes with filling defects were metastatic (21/30, 70 per cent). The sensitivity, specificity, accuracy, and positive and negative predictive values when using a filling defect diameter of 1.5 mm as a diagnostic criterion were 86.4, 78.9, 82.9, 82.6 and 83.3 per cent, respectively.Conclusion:When using indirect computed tomography lymphography to detect metastatic lymph nodes, filling defects and slow evacuation of contrast agent are important diagnostic features.

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Outcome of lymph node tuberculosis management with conventional treatment with and without prednisolone

Tropical Doctor ◽

10.1177/0049475520984745 ◽

2021 ◽

pp. 004947552098474

Author(s):

Arjuman Sharmin ◽

Ali Hossain ◽

Nazmul Islam ◽

Zakir H Sarker ◽

Sheikh S Hossain ◽

...

Keyword(s):

Clinical Trial ◽

Lymph Node ◽

Complete Resolution ◽

Conventional Treatment ◽

Symptomatic Improvement ◽

Control Group ◽

Controlled Clinical Trial ◽

Open Label ◽

Lymph Node Tuberculosis ◽

And Control

The outcome of lymph node tuberculosis (LNTB) management with conventional anti-tubercular treatment alone is unsatisfactory. We conducted a randomised open-label controlled clinical trial in the Department of Respiratory Medicine in Government Institute of Dhaka, Bangladesh from April 2017 to March 2019. Compared with controls, 54 patients of LNTB received category 1 anti-tubercular treatment with additional prednisolone after randomisation. Complete resolution in 21/54 (75%) and 7 (26.9%), symptomatic improvement in 26 (92.9%) and 22 (84.6%) and complications in 11 (39.28%) and 16 (61.53%) were observed in the treatment and control group, respectively. Thus, we recommend the use of steroids in this setting.

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Severe Paradoxical Reaction Requiring Tracheostomy in a Human Immunodeficiency Virus (HIV)-negative Patient with Cervical Lymph Node Tuberculosis

Yonsei Medical Journal ◽

10.3349/ymj.2008.49.5.853 ◽

2008 ◽

Vol 49 (5) ◽

pp. 853 ◽

Cited By ~ 3

Author(s):

In-Suh Park ◽

Dongwook Son ◽

Chanwoo Lee ◽

Jae Eun Park ◽

Jin-Soo Lee ◽

...

Keyword(s):

Human Immunodeficiency Virus ◽

Lymph Node ◽

Cervical Lymph Node ◽

Paradoxical Reaction ◽

Negative Patient ◽

Immunodeficiency Virus ◽

Lymph Node Tuberculosis ◽

Hiv Negative

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Presurgical, ultrasound-guided anchor-wire marking of impalpable cervical lymph nodes

The Journal of Laryngology & Otology ◽

10.1258/0022215054516241 ◽

2005 ◽

Vol 119 (8) ◽

pp. 627-628 ◽

Cited By ~ 13

Author(s):

J A Bryant ◽

N J Siddiqi ◽

E J Loveday ◽

G H Irvine

Keyword(s):

Lymph Node ◽

High Risk ◽

Lymph Nodes ◽

Cervical Lymph Node ◽

Ultrasound Guidance ◽

Operating Time ◽

High Risk Patient ◽

Wire Localization ◽

Ultrasound Guided ◽

Cervical Lymph Nodes

This case illustrates the surgical use of wire localization, a well tried technique from a different field of surgery, in the removal of an ultrasound-detected, impalpable deep lower cervical lymph node in a high-risk patient. A localization needle with an echogenic tip was placed freehand under ultrasound guidance, immediately before surgery. The imaging and marking of the impalpable cervical lymph node resulted in a precise surgical dissection and a reduction in operating time whilst minimizing risks to the patient and staff.

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A Study of FNAC of Cervical Lymph Nodes

Journal of Nepal Health Research Council ◽

10.3126/jnhrc.v7i1.2267 ◽

1970 ◽

Vol 7 (1) ◽

pp. 1-5 ◽

Cited By ~ 3

Author(s):

G Shakya ◽

S Malla ◽

KN Shakya ◽

R Shrestha

Keyword(s):

Lymph Node ◽

Fine Needle Aspiration ◽

Fine Needle Aspiration Cytology ◽

Cervical Lymph Node ◽

Cervical Lymphadenopathy ◽

Needle Aspiration ◽

Aspiration Cytology ◽

Cervical Lymph Nodes ◽

Fine Needle ◽

Needle Aspiration Cytology

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

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Lymphogranuloma Venereum: a Croatian Case Report of a Patient with Proctitis and Concurrent Cervical Lymphadenitis

Open Forum Infectious Diseases ◽

10.1093/ofid/ofx163.104 ◽

2017 ◽

Vol 4 (suppl_1) ◽

pp. S106-S106

Author(s):

Branimir Gjurasin ◽

Josip Begovac

Keyword(s):

Case Report ◽

Lymph Node ◽

Cervical Lymph Node ◽

Rectal Swab ◽

Cervical Lymphadenopathy ◽

Lymphogranuloma Venereum ◽

Purulent Discharge ◽

Fine Needle Aspirate ◽

Cervical Lymphadenitis ◽

Fine Needle

Abstract Background Lymphogranuloma venereum (LGV) can present with genital ulcers, proctitis, or femoral/inguinal lymphadenopathy with or without constitutional symptoms. There have been reports on the infection characterized by supraclavicular or cervical lymphadenopathy, although there is no published data on the detection of Chlamydia trachomatis (CT) in the affected lymph node. Methods We report a patient with pharyngitis, proctitis and cervical lymphadenitis, in whom LGV specific DNA was detected by polimerase chain reaction (PCR) in both the rectal swab and cervical lymph node fine needle aspirate. Results A 48-year-old Croatian HIV-positive male patient attended our outpatient HIV clinic complaining of a 10-day perianal pain, bloody rectal discharge with normal stool consistency and painful and enlarged cervical lymph node. On the first day he had fever, which subsided on the following day. Clinical examination demonstrated exudate on the right tonsil, painful, and enlarged right cervical lymph node (5 × 2 cm, Figure 1), perianal pain on palpation and rectal purulent discharge. During the preceding 10-year period, the patient was taking his antiretroviral therapy regularly and had an undetectable HIV RNA by PCR. We started treatment with ceftriaxone and doxycycline. The fine needle aspirate of the affected lymph node showed a pyogranulomatous inflammation. Indirect immunofluorescence assay on CT antibodies detected positive titers in IgG (>512) and IgA (256) classes. LGV-specific DNA was detected in both the rectal swab and the cervical lymph node fine needle aspirate. Ceftriaxone was discontinued after 5 days and doxycycline therapy was continued for a total of 6 weeks because of the persistence of the cervical lymphadenopathy. The patient came to a full recovery. Conclusion We found six published case reports on LGV with associated cervical lymphadenopathy in which the infection with CT was established by serologic testing and/or by nucleic acid amplification tests of the pharyngeal and/or rectal swabs. Some of the mentioned reports demonstrated granulomatous inflammation present in the affected cervical lymph node, as was evidenced in our patient. To our knowledge, this is the first case report of a patient with CT infection in whom LGV-specific DNA was detected in the cervical lymph node. Disclosures All authors: No reported disclosures.

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