Clinical pattern of tuberculous adenitis in Qatar: experience with 35 patients

A prospective observational study was conducted to describe the clinical presentation, diagnostic yield of fine-needle aspiration (FNA) cytology and lymph node biopsy and the outcome of tuberculous (TB) adenitis in patients admitted to Hamad General Hospital, Qatar, between 1 January and 31 December 2006. TB adenitis that was predominantly cervical was confirmed in 35 patients (28M, 7F) with a mean age of 29.4+/-9 y. Of the 35 cases, caseating granulomata were confirmed by FNA in 20, by lymph node biopsy following negative FNA in 9, and by biopsy alone in 6. Mycobacterium tuberculosis was cultured from FNA alone in 24 cases, in 9 cases from biopsies after negative FNA and in 6 cases from biopsies alone. The tuberculin test (PPD) was positive in all patients with TB adenitis (100%), while an HIV test was negative in all. The sensitivity of FNA cytology alone was 69% but when combined with a skin test it was 85%. It can be concluded that FNA cytology has an important role in the evaluation of TB adenitis, as a non-invasive alternative to excisional biopsy. After 12 months from the start of a 6-month course of combined antituberculous treatment, 32 patients were cured whereas 3 patients had left the country before completing therapy.