[Evaluation of 694 tuberculous lymphadenitis cases reported from Turkey between 1997-2009 period by pooled analysis...

Tuberculosis which mainly involves the lungs, can also cause infection in almost all other organs and tissues in the body. One of the most common forms of extrapulmonary tuberculosis is tuberculous lymphadenitis. In this study, tuberculous lymphadenitis cases reported from Turkey in national and international journals in the last 12 years, were reviewed systematically with pooled-analysis method. Related articles were retrieved by search of three national (Ulakbim Turkish Medical literature databases, http://www.turkishmedline.com, http://medline.pleksus.com.tr) and two international databases [PubMed and Science Citation Index (SCI)]. Between the years 1997-2009, tuberculous lymphadenitis cases have been published in a total of 44 articles (13 international, 31 national data base). These articles included a total of 694 tuberculous lymphadenitis cases (62.4% women, 37.6% men; mean age 37.5 years). The distribution of the lymph nodes involved was determined in 528 cases and the most commonly involved areas were cervical (61.4%), mediastinal (20.5%) and axillary (6.4%) areas. The most common complaints of patients were fever (15.8%), weight loss (14.5%), malaise-fatigue (13.1%) and sweating (12.4%). Tuberculous lymphadenitis was identified in 10.6% (51/479) of the cases by direct microscopical examination, in 15.9% (65/408) by culture and in 648 cases from whom biopsies were taken, by histopathological examination. Tuberculin skin test positivity was detected in 78.9% (377/478) cases. History of contact with active tuberculosis patients was determined in 24.2% (88/364) of the patients. Coexisting lung tuberculosis was detected in 7.8% (54/694) of the cases. The total number of cases that had died was four; two cases due to malignancy, one due to sepsis and one due to central nervous system tuberculosis that have developed four years following the diagnosis of tuberculous lymphadenitis. Since microbiological diagnosis is difficult in tuberculous lymphadenitis and not available in all centers, evaluation of the patients' history and clinical findings are of great importance. This pooled analysis which enabled the evaluation of a large number of tuberculous lymphadenitis cases, indicated that in countries where tuberculosis is widespread, careful evaluation of clinical findings and a good microbiological and histopathological investigation will provide valuable support for diagnosis and treatment of tuberculous lymphadenitis.