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PubMed2002

Comparative cytological study of lymph node tuberculosis in HIV-infected individuals and in patients with diabetes in a developing country.

Tuberculosis (TB) is a common infection affecting patients with human immunodeficiency virus (HIV) and diabetes mellitus (DM). With the increasing incidence of HIV infection and DM in a developing country like India, TB is definitely on the rise. In a given population, one expects to see these three diseases in varying combinations, such as HIV and TB, DM and TB, HIV and DM with TB. In such combinations TB may lack the characteristic clinical and histological picture due to the associated depressed cell-mediated immunity seen in both diseases and TB may have an unusual clinical presentation and cytology picture. In this retrospective study of 36 months, from January 1997 to December 1999, 109 cases diagnosed cytologically as tuberculous lymphadenitis and tested for HIV infection and investigated as well for DM were selected. Forty-six (42%) were nondiabetic HIV patients, 13 (12%) were non-HIV DM patients, and 50 (46%) had TB without HIV infection or DM. The coexistence of both HIV and DM was not noted. The cytomorphological characteristics supplemented by culture studies of each of these three groups were compared in detail and based on these four cytological patterns, Pattern 1, Pattern 2, Pattern 3, and Pattern 4 emerged and were characterized. This study highlights the usefulness of cytomorphology of the lymph nodes to characterize the cytopathological profile of TB in both HIV and DM, which have many clinical and immunological similarities, and indirectly postulate the extent of immune suppression and evolve effective strategies in the management of coexisting diseases. Such a comparative study has not been carried out in the past.

Acquired Immunodeficiency Syndrome↗
PubMed1996

[Current aspects of lymph node tuberculosis of the neck].

In 1994, the incidence of tuberculosis (Tb) in Germany is 16/ 100,000, and the incidence of extrapulmonary Tb is 2,3/100,000. The peripheral lymph nodes represent with 41% the most commonly involved extrapulmonary organ system. At present, cervical lymph node Tb is of clinical relevance on one hand in patients from endemic areas of Tb in the developing countries and on the other hand in immunocompromised patients, particularly in course of HIV infection. Diagnostic methods are discussed with special attention to fine needle biopsy; modalities and indications of imaging methods are described. The microbiological examination allows the definitive diagnostic clarification. Cervical lymph node Tb responds well to antituberculous chemotherapy. Regimens of drug combination and the duration of treatment are discussed; generally chemotherapy should be continued for at least 9 months. Indications to surgical intervention are explained. The different aspects of adenopathies caused by atypical mycobacteria are considered.

AIDS-Related Opportunistic Infections↗
PubMed2006

A boy undergoing maintenance hemodialysis who developed mediastinal lymph node tuberculosis.

The incidence of tuberculosis (TBC) in patients undergoing maintenance hemodialysis is reported to be higher than that in the general population. We report an 8-year-old boy receiving such treatment for chronic renal failure who developed mediastinal lymph node TBC. He showed only intermittent fever, recurring every 2 weeks, with no other symptoms suggesting TBC. Although staining and culture of pharyngeal swab and gastric juice specimens failed to provide evidence of TBC, a lymph node biopsy specimen disclosed typical pathologic findings of tuberculoma, including caseating granulomas. Antituberculous therapy with isoniazid (INH), rifampicin, pyrazinamide, and ethambutol was given for 12 months, resulting in complete resolution of the TBC, with no subsequent recurrence. To our knowledge, mediastinal lymph node localization of TBC is relatively rare, in a patient on maintenance hemodialysis, especially in a child.

Child↗
PubMedDate not supplied

[Lymph node tuberculosis in adults].

Tuberculous lymphadenitis is a form of extrapulmonary tuberculosis that was observed in 8.4% of all cases with tuberculosis in our series. In all instances the organism isolated was M. tuberculosis. There was a high rate of PPD positiveness. The chemotherapy yielded good results. The evolution was satisfactory in 75% of the patients treated for six months.

Adolescent↗
PubMed2005

[An adult case of cervico-mediastinal lymph nodes tuberculosis followed by the development of pulmonary lesions during the treatment with antituberculous drugs].

A 27-year-old man was admitted to our hospital due to a painful mass in the right neck and fever. Cervical and superior mediastinal computed tomography showed an enlargement of right supraclavicular lymph node and multiple swollen mediastinal lymph nodes, including low-density areas and contrast medium-enhanced septa and margins. Smears of the pus obtained from right supraclavicular lymph node showed acidfast bacilli identified as Mycobacterium tuberculosis by PCR method. He was treated with antituberculous drugs with INH, RFP, EB, and PZA. PZA was given for initial two months. Six months later, productive cough developed and chest X-ray films showed infiltrative shadow in the right upper lung field. One month after the onset of cough, bronchoscopy revealed a polypoid lesion with a white coating in the right main bronchus. Microscopic examination of the specimen obtained by transbrochial biopsy revealed many epithelioid cell granulomas, consistent with tuberculosis. From these findings, pulmonary lesion was suggested to be due to invasion of the mediastinal lymph node into the bronchus. After one year of antituberculous chemotherapy, the swelling of the cervical-mediastinal lymph nodes was reduced and the abnormal chest X-ray shadows disappeared.

Adult↗
PubMed1990

Peripheral lymph node tuberculosis: a review of 80 cases.

One hundred and ninety-two patients with peripheral lymphadenopathy were screened and 80 patients with tubercular lymphadenitis were studied. Their ages ranged from 1 to 65 years; most were younger than 30 years and there was a slight female preponderance (1.2:1). Seventy per cent of patients were of low socioeconomic status. Of the 80 patients, 56 had affected cervical nodes, seven had inguinal nodes, five had axillary nodes and 12 had multiple sites of lymph node involvement. All had enlarged nodes which were matted in 44 cases and discrete in 18 cases, while the rest had either an abscess or a discharging sinus. Fifty-nine cases (74 per cent) showed a positive Mantoux test and four cases (5 per cent) had associated pulmonary tuberculosis. Fine needle aspiration cytology gave a positive diagnosis in 66 cases (83 per cent). Fifty-two cases showed a positive culture for Mycobacterium tuberculosis of human type in Lowenstein-Jensen medium. Short-term chemotherapy (9 months) consisting of rifampicin, isoniazid and ethambutol gave an excellent result. Surgery was not required in any of the cases.

Adolescent↗
PubMed1990

[Abdominal lymph node tuberculosis: a diagnostic surprise].

The case of a patient submitted to sonographic abdominal examination because of recent onset of fever, abdominal pain and weight loss, with the finding of multiple enlarged lymph nodes along great vessels, is reported. Because of the negativity of noninvasive procedures, the patient underwent laparatomy and biopsy. The histologic and bacteriologic diagnosis of tuberculous lymphnodes was unexpected, as the patient was unreactive to the tuberculin skin test and had no signs of active pulmonary tuberculosis. Although uncommon, tuberculosis must be included in the differential diagnosis of subdiaphragmatic lymphadenopathies even if symptoms of mycobacterial infection or other signs of the infections are not presented.

Abdomen↗
PubMedDate not supplied

[Lymph node tuberculosis in Cameroon: clinical and anatomo-pathologic aspects; apropos of 333 cases].

For a period of 11 years and 7 months (1st January 78-31 July 89), 1950 lymph nodes were received in the pathology laboratory of Cameroon. 333 of these, that is 17% revealed typical lesions of tuberculosis. Analysing the information associated to these tuberculoid adenitis revealed that: 46% of the patients were less than 10 years of age; 83.8% of the specimens were taken from the cervical region. 78% of patients had fever, cough was complained of by 56% and 40% had polyadenopathies. Finally, 81% of the tuberculoid lymph nodes analyzed had a diameter less than 5cm while only 33% showed acid fast bacilli on direct examination (Ziehl-Neelsen staining method) on the histologic slides.

Adolescent↗
PubMed2001

Ten-year experience with paediatric lymph node tuberculosis in Port Moresby.

This is a descriptive study of short-course chemotherapy in children with nodal tuberculosis at Port Moresby General Hospital (PMGH). Between 1 August 1989 and 31 December 1997 5248 children were started on TB treatment. In the retrospective study 427 children were treated for lymph node TB up to 31 December 1996. Of these, 207 definitely completed the treatment and 24 (11.6 per cent) of them were known to have relapsed up to the end of 1997. In the prospective study 179 children with lymph node TB were enrolled between 1 January 1997 and 31 December 1997. Of these, 97 definitely completed the treatment and 10 (10.6 per cent) were known to have relapsed during a follow-up period of between 1 and 2 years.

Adolescent↗
PubMedDate not supplied

[Incidental diagnosis of lymph node tuberculosis in an 111-indium-octreotide scintigraphy during a study of acromegaly].

A patient with clinical suspicion of acromegaly and no radiologic visualization of pituitary adenoma is presented. (111)In-DTPAOC scintigraphy was performed in order to localize an ectopic foci of GH production. Scintigraphy showed uptake in right paratracheal and hiliar lymph nodes that seemed residual in CT. Biopsy through mediastinoscopy showed tuberculous granulomas. After treatment, scintigraphy normalized. This case illustrate that (111)In-DTPAOC can be positive not only in tumoral but in benign pathology and, in specific cases, it can be a marker of inflammatory activity and useful for treatment monitoring.

Acromegaly↗