BACKGROUND. Lymph node tuberculosis is a pathology with an increasing incidence and prevalence in middle income countries.
MATERIAL AND METHODS. We present a series of 4 cases with cervical lymph node tuberculosis. We review current principles of diagnosis and treatment from the perspective of the ENT surgeon in a tertiary university clinic.
RESULTS. In each case we underline diagnosis difficulties and treatment options. These cases presented management difficulties due to associated morbidities. All cases underwent surgical excision of the afflicted lymph nodes with subsequent microscopic confirmation of tuberculosis. We illustrate key concepts leading to the microscopy diagnosis of lymph node tuberculosis.
CONCLUSION. There are various surgical incidents and accidents that the young surgeon must be aware of when approaching neck tuberculous lymph nodes. Further referral of the patient for long-term tuberculosis treatment is mandatory. All patients were supervised for a minimum of 1 year after the initial diagnosis and treatment with no sign of recurrence. A close cooperation between the ENT surgeon, the infectious disease specialist and the pathologist is the key to an optimum approach to lymph node tuberculosis at the head and neck level.
If the inline PDF is not rendering correctly, you can download the PDF file here.
1. Benjelloun A Darouassi Y Zakaria Y Bouchentouf R Errami N. Lymph nodes tuberculosis: a retrospective study on clinical and therapeutic features. Pan Afr Med J. 2015;20:65. DOI: 10.11604/pamj.2015.20.65.5782. eCollection 2015.
2. Ryu YJ. Diagnosis of pulmonary tuberculosis: recent advances and diagnostic algorithms. Tuberc Respir Dis (Seoul). 2015;78(2):64-71. DOI: 10.4046/trd.2015.78.2.64.
3. Martinez BG Di Martino OB Rodriguez MM Knopfelmacher O Bolla de Lezcano L. Ganglionar tuberculosis with skin involvement (scrofuloderma) in an inmmunocompetent patient. A case report. N Dermatol Online. 2011;2(3):130-4.
4. Branco C Subtil J Tomas L Pereira AM. Tuberculose ganglionar cervical: a propósito de um caso clínico. Tuberculosis lymphadenitis: case report. Rev Port ORL. 2005;43(3):257-64.
5. Costache A Dumitru M Anghel I Cergan R Anghel AG Sarafoleanu C. Ultrasonographic anatomy of head and neck – a pictorial for the ENT specialist. Med Ultrason. 2015;17(1):104-8. DOI : 10.11152/mu.2013.2066.717.aco.
6. Deveci HS Kule M Kule ZA Habesoglu TE. Diagnostic challenges in cervical tuberculous lymphadenitis: A review. North Clin Istanb. 2016;3(2):150-5. DOI: 10.14744/nci.2016.20982.
7. Zaldivar RFR Hurtado LLM Ramirez TD. Tuberculous lymphadenopathy of the neck: A diagnosis that should not be forgotten. Cir Gen. 2004;26(3):177-80.
8. Kumar H Chandanwale SS Gore CR Buch AC Satav VH Pagaro PM. Role of fine needle aspiration cytology in assessment of cervical lymphadenopathy. Med J DY Patil Univ. 2013;6:400-4. DOI: 10.4103/0975-2870.118287.
9. Baek CH Kim SI Ko YH Chu KC. Polymerase chain reaction detection of Mycobacterium tuberculosis from fine-needle aspirate for the diagnosis of cervical tuberculous lymphadenitis. Laryngoscope. 2000;110(1):30-4.
10. Kanlikama M Gokalp A. Management of mycobacterial cervical lymphadenitis. World J Surg. 1997;21(5):516-9.