A clinical study of tuberculous cervical lymphadenopathy cases presenting in a tertiary care hospital in M.P.

Author(s): Ashutosh Chaturvedi1, Ashutosh Singh2, Sheru Singh Rajput3, Sunil Yadav1
1M.D. Respiratory Medicine Senior Resident, Respiratory medicine, GMC Bhopal.
2M.D. Respiratory Medicine Senior Resident, MGM Super Specialty Hospital, Indore.
3M.D. Respiratory Medicine Senior Resident, Respiratory medicine, GMC Shivpuri.
Copyright © Ashutosh Chaturvedi, Ashutosh Singh, Sheru Singh Rajput, Sunil Yadav. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

This study aimed to clinically investigate cases of tuberculous lymphadenopathy in a tertiary care center in Madhya Pradesh. 67 patients with swelling in the neck and clinically diagnosed as Cervical Tuberculous Lymphadenopathy were included. Data was collected through detailed history, physical examination, routine investigations, radiological tests, and FNAC. Most participants were females (56.7%) in the 11-20 years age group (32.8%). Chest X-ray/ CT thorax findings showed infiltrates in 7.5%. Mantoux test was positive in 85.1% participants. FNAC revealed granuloma without caseous necrosis in 80.6% cases, with AFB found in 28%. 91% were treated with ATT only, while 6% were treated with ATT+ART. 28.4% experienced a paradoxical reaction during treatment, with 94.7% undergoing modification of treatment. USG neck at the end of 6 months treatment revealed residual lymph nodes in only 20.9%. 22.4% required an extended duration of treatment. The study concludes that cervical lymph node tuberculosis is the most common form of extra-pulmonary tuberculosis and FNAC is the simplest procedure for diagnosis. The presence of residual LNs after 6 months of anti-tuberculosis treatment does not necessarily indicate recurrence or treatment failure but must be re-evaluated and differentiated from active TB.

Keywords: Tuberculous cervical lymphadenopathy; Residual lymph nodes; FNAC; ATT.