Clinical and morphological evaluation of tuberculous peripheral lymphadenopathy

To analyze clinical presentations in patients of tuberculous peripheral lymphadenopathy.

a descriptive observational study.

Department of Chest medicine, Jinnah Postgraduate Medical Centre and National Institute of Child Health from January to June 2002.

Patients presenting with peripheral lymphadenopathy with the confirmed diagnosis of tuberculous were included in the study. The diagnosis of tuberculosis was made on finding acid fast bacilli on smear examination and / or histological demonstration of caseating epithelioid cell granulomas in the specimen obtained by fine needle aspiration cytology (FNAC) or excision biopsy. Patients in whom definite diagnosis of tuberculosis was not established on the basis of microscopy or histopathology examination were excluded from the study. History and physical examination findings were recorded on pre-designed proforma.

the maximum number of patients (68.75 %) was in pediatric age group. The duration of illness was more than a year in 43.75% of the patients. Cervical region was the commonest affected in 70.83 % patients. In majority of cases (89.58 %) glands were multiple and in 66.7% glands were matted. In 83% cases diagnosis was achieved by FNAC subjected for cytology and acid fast bacilte (AFB) smear examination.

In local setting tuberculous etiology should be strongly suspected in a young patient presenting with peripheral lymphadenopathy, with prolonged duration of illness, and involvement of cervical glands with multiple and matted appearance. FNA is a reliable tool of diagnosis.