Analysis Of Treatment Outcome of Superficial Tuberculous Lymphadenitis on The Basis of Cytomorphological Features

Authors

  • Nilesh C Dutt Smt. N.H.L. Municipal Medical College, Ahmedabad
  • Anil M Gupta Smt. N.H.L. Municipal Medical College, Ahmedabad

Keywords:

Tuberculosis, tuberculous lymphadenitis, outcome, treatment failure

Abstract

Introduction: Cases of tuberculouse lymphadenitis continue to present clinical hurdles in successful treatment outcome.This study was aimed to analyze the cytomorphological features in superficial tuberculous lymphadenitis and to analyze the treatment outcome on the basis of these features.

Methods: The present study was carried out in 60 patients of superficial palpable lymph nodes. All cases were subjected to fine needle aspiration of the lymphnodes.

Results: Majority of patients were female and below 30 years of age. Cervical lymphnodes were most commonly involved 42(70%). It was seen that 48(80%), the lymphnodes had completely resolved.9 were considered as failures. Cases were divided into 4 groups depending on cytopathological features i.e. group I- Abscess (15), group II- Caseous necrosis(16),group III-Epitheloid grenuloma with caseation(17) and group IV Epitheloid grenuloma without caseation(12) one patient from group I and one patient from group III defaulted. On follow –up with AKT group IV patients responded best. Cases with group IV cytopatholofical features had no failures (100% cure) while group I, group II, group III had 70%, 72% and 92.3% success rate respectively. Among the necrotizing lesion the best prognosis was seen in grenuloma without caseation.

Conclusion: Tuberculous lymphadenitis is more common in females with cervical lymph nodes most commonly involved.Presense of necrosis in lesions had greater chances of non- regression and failures.

References

S. Qadri, N.Hamdani, P Shah, M Lone, K.Baba Profile of Lymphadenopathy in Kashmir Valley: a Cytologi-cal Study Asian Pacific J Cancer Prev, 13, 3621-3625

World Health Organization (WHO). Treatment of Tuberculosis. Guidelines for National Programmes, 3rd ed. WHO/CDS/TB 2003.313. Geneva, Switzer-land: WHO, 2003

P.R. Gupta, DIFFICULTIES IN MANAGING LYMPH NODE TUBERCULOSIS Lung India 2004; 21 : 50-53

Polesky A, Grove W, Bhatia G. Peripheral tuberculous lymphadenitis:epidemiology, diagnosis, treatment, and outcome. Medicine (Baltimore)2005; 84:350–62.

Peto HM, Pratt RH, Harrington TA, LoBue PA, Arm-strong R.Epidemiologyofextrapulmonary tuberculosis in the United States, 1993–2006. Clin Infect Dis 2009; 49:1350–7.

Wei YF, Liaw YS, Ku SC, Chang YL, Yang PC. Clinical features and predictors of a complicated treatment course in peripheral tuberculous complicated treat-ment course in peripheral tuberculouslymphadenitis. J Formos Med Assoc 2008; 107:225–31.

Khan FY. Clinical pattern of tuberculous adenitis in Qatar: experience with 35 patients. Scand J Infect Dis 2009; 41:128–34.

Purohit MR, Mustafa T, Morkve O, Sviland L. Gender differences inthe clinical diagnosis of tuberculous lymphadenitis—a hospital-basedstudy from Central India. Int J Infect Dis 2009; 13:600–5.

CTD. Revised National TB Control Programme. Tech-nical guidelines for TB Control. New Delhi:CTD, 1997.

Jawahar, M.S., Sivasubramanian, S., Vijayan, V.: Short-course chemotherapy for tuberculous lymphad-enitis in children. BMJ 1990;301:359-62.

Prasad, R.R., Narasimhan, Sankaran V., Neliath, A.J.: Fine needle aspiration cytology in the diagnosis of su-perficial lymphadenopathy: an analysis of 108 cases. Diagnosis Cytopathol 1996;15:382-6.

Wright CA, van der Burg M, Geiger D, Noordzij JG, Burgess SM, Marais BJ. Diagnosing mycobacterial lymphadenitis in children using fine needle aspiration biopsy: cytomorphology, ZN staining and autofluo-rescence—making more of less. Diagn Cytopathol 2008; 36:245–51.

Asimacopoulos EP, Berry M, Garfield B, et al. The diagnostic efficacy of fine-needle aspiration using cy-tology and culture in tuberculous lymphadenitis. Int J Tubercle Lung Dis 2010; 14:93–8.

Ellison E, Lapuerta P, Martin SE. Fine needle aspira-tion diagnosis of mycobacterial lymphadenitis. Sensi-tivity and predictive value in the United States. Acta Cytol 1999; 43:153–7.

Singh KK, Muralidhar M, Kumar A, et al. Compari-son of in house polymerase chain reaction with con-ventional techniques for the detection of Mycobacte-rium tuberculosis DNA in granulomatous lymphade-nopathy. J Clin Pathol 2000; 53:355–61.

van Wyk AC, Marais BJ, Warren RM, van Wyk SS, Wright CA. The use of light-emitting diode fluores-cence to diagnose mycobacterial lymphadenitis in fi-ne-needle aspirates from children. Int J Tubercle Lung Dis 2011; 15:56–60.

Khan R, Harris SH, Verma AK, Syed A. Cervical lym-phadenopathy: scrofula revisited. J Laryngol Otol 2009; 123:764–7.

Daley P, Thomas S, Pai M. Nucleic acid amplification tests for the diagnosis of tuberculous lymphadenitis: a systematic review. Int J Tuberc Lung Dis 2007; 11:1166–76.

Hillemann D, Ruesch-Gerdes S, Boehme C, Richter E. Rapid molecular detection of extrapulmonary tuber-culosis by automated GeneXpert(R) MTB/RIF sys-tem. J Clin Microbiol 2011; 49:1202–5.

Treatment of tuberculosis. Centers for Disease Con-trol. MMWR Recomm Rep 2003; 52:1–77.

Cho OH, Park KH, Kim T, et al. Paradoxical respons-es in non-HIVinfected patients with peripheral lymph node tuberculosis. J Infect 2009; 59:56–61.

Hawkey CR, Yap T, Pereira J, et al. Characterization and management of paradoxical upgrading reactions in HIV-uninfected patients with lymph node tubercu-losis. Clin Infect Dis 2005; 40:1368–71.

Blaikley JF, Khalid S, Ormerod LP. Management of peripheral lymph node tuberculosis in routine prac-tice: an unselected 10-year cohort. IntJ Tuberc Lung Dis 2011; 15:375–8.

Wallis RS. Reconsidering adjuvant immunotherapy for tuberculosis.Clin Infect Dis 2005; 41:201–8.

Ammari FF, Bani Hani AH, Ghariebeh KI. Tuberculo-sis of the lymph glands of the neck: a limited role for surgery. Otolaryngol Head Neck Surg 2003; 128:576–80.

Lindeboom JA, Kuijper EJ, Bruijnesteijn van Cop-penraet ES, Lindeboom R, Prins JM. Surgical excision versus antibiotic treatmentfor nontuberculous myco-bacterial cervicofacial lymphadenitis in children:a multicenter, randomized, controlled trial. Clin Infect Dis 2007; 44:1057–64.

Zeharia A, Eidlitz-Markus T, Haimi-Cohen Y, Samra Z, Kaufman L,Amir J. Management of nontubercu-lous mycobacteria-induced cervicallymphadenitis with observation alone. Pediatr Infect Dis J 2008; 27:920–2.

Griffith DE, Aksamit T, Brown-Elliott BA, et al. An official ATS/IDSAstatement: diagnosis, treatment, and prevention of nontuberculous mycobacterial dis-eases. Am J Respir Crit Care Med 2007;175:367–416.

Garcia Vidal C, Garau J. Systemic steroid treatment of paradoxical upgrading reaction in patients with lymph node tuberculosis. Clin Infect Dis 2005; 41:915–6; author reply 6–7.

Downloads

Published

2014-12-31

How to Cite

1.
Dutt NC, Gupta AM. Analysis Of Treatment Outcome of Superficial Tuberculous Lymphadenitis on The Basis of Cytomorphological Features. Natl J Community Med [Internet]. 2014 Dec. 31 [cited 2024 Mar. 29];5(04):474-9. Available from: https://njcmindia.com/index.php/file/article/view/1441

Issue

Section

Original Research Articles