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[Tuberculous lymphadenitis]

M Kato1, T Kinoshita

  • 1National Sengokuso Hospital, Division of Pulmonary Medicine.

Nihon Rinsho. Japanese Journal of Clinical Medicine
|January 12, 1999
PubMed
Summary

Tuberculous lymphadenitis, a common extrapulmonary tuberculosis, is often detected using computed tomography (CT). Active cases show specific CT findings, aiding diagnosis and treatment decisions.

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Area of Science:

  • Medical Imaging
  • Infectious Diseases
  • Radiology

Context:

  • Tuberculous lymphadenitis is a frequent extrapulmonary form of tuberculosis, accounting for approximately 28% of cases.
  • While chest X-rays can reveal pulmonary hilar and mediastinal lymphadenitis, abdominal lymphadenitis is less detectable.
  • Computed tomography (CT) offers a valuable method for visualizing both mediastinal and abdominal tuberculous lymphadenitis.

Purpose:

  • To highlight the utility of computed tomography (CT) in detecting tuberculous lymphadenitis, particularly in the abdomen.
  • To describe the characteristic CT findings differentiating active from inactive tuberculous lymphadenitis.
  • To outline diagnostic and treatment approaches for tuberculous lymphadenitis.

Summary:

  • Computed tomography (CT) is effective for detecting tuberculous lymphadenitis, including abdominal cases often missed by chest X-rays.
  • Active tuberculous lymphadenitis typically presents with central low attenuation and peripheral rim enhancement on contrast-enhanced CT.
  • Inactive tuberculosis may show homogeneous patterns without low attenuation and often exhibits calcification.
  • Bacterial diagnosis can be challenging, but the Polymerase Chain Reaction (PCR) method proves effective.
  • Standard anti-tuberculous chemotherapy is the primary treatment, with surgical intervention considered for fistula formation.

Impact:

  • Enhanced diagnostic accuracy for tuberculous lymphadenitis through advanced imaging techniques.
  • Improved differentiation between active and inactive disease stages based on CT characteristics.
  • Guidance for effective treatment strategies, including chemotherapy and surgical options for complex cases.

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