DefinePK

Abstract

Background and Objectives: Among extra pulmonary tuberculosis, cervicallymph node involvement is very common. This prospective study was done toobserve the clinical manifestation of the disease and histologic pattern andtreatment involved and follow-up.Methods: Patients were enrolled from outpatient clinics of otolaryngology(ENT) and medicine departments of Ziauddin Hospital Kemari Campus withneck lumps. Lymphadenopathy secondary to acute ear nose throat and dentalinfections and cases with concurrent pulmonary tuberculosis were excluded.The cervical lymphadenopathy due to other causes like neck metastasis ofprimary head and neck neoplasia, and chronic inflammatory causes likesarcoidosis and kikuchi's disease were also excluded. Clinical work-upincluded history and detailed examination of ENT including fibrelaryngoscopy.Investigations included a complete blood picture, Erythrocyte sedimentationrate (ESR), Mantoux test, chest radiograph, and fine needle aspiration (FNA)cytology in all cases with excision biopsies in cases where FNA was inconclusive.Antituberculous therapy initiated and the cases were followed up for oneyear.Results: There were 46 cases (36 females) recruited from January 2010 toDecember 2013 out of a total sample of 68; mean age was 22 years. Most cases (74%) had fever at presentation while 96% had a raised ESR. Most (82%) had unilateral enlargement of lymph nodes, 80% of them being in the posterior triangle of neck. All the cases had normal chest radiograph. In 17 of the cases FNAC was diagnostic while in the rest of 29 cases diagnosis was made by histopathology of resected nodes. The antituberculous treatment was givenfor 6 months and the follow-up done for one year. Satisfactory results yielded inall cases with lessening in the sizes of lump and good symptomatic reliefsConclusions: Tuberculosis was the most significant cause of necklymphadenopathy in this cohort. Almost all cases can be diagnosed withhistopathology although the yield of FNA in our series was lower. Most casescan be managed as easily and involvement of physicians trained in tuberculosisis useful.