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[Head and neck lymph node lesions]
Insights
Enlarged lymph nodes (LN) in adults were often caused by tuberculosis, especially in women, and cancer. Diagnosis of lymph node tuberculosis using the Mantoux test proved unreliable.
Area of Science:
- Pathology
- Microbiology
- Oncology
Background:
- Enlarged lymph nodes (LN) are a common clinical finding requiring accurate diagnosis.
- Puncture cytology is a key diagnostic tool for evaluating LN abnormalities.
Purpose of the Study:
- To analyze the causes of enlarged lymph nodes diagnosed via puncture cytology.
- To investigate the prevalence and diagnostic challenges of lymph node tuberculosis (LNTB).
Main Methods:
- Retrospective analysis of 134 patients undergoing puncture cytological diagnosis for enlarged lymph nodes.
- Bacterioscopic examination of M. tuberculosis in puncture biopsies.
- Evaluation of the Mantoux test's efficacy in diagnosing LNTB.
Main Results:
- Nonspecific inflammation (38.6%), hyperplasia (26.3%), tuberculosis (18.5%), and cancer metastases (14.9%) were the primary causes of LN enlargement.
- Lymph node tuberculosis was significantly more frequent in adult women (2/3 of LNTB cases) than in children (3.7%).
- Bacterioscopic detection of M. tuberculosis was low (28.6%), and the Mantoux test was unreliable for peripheral LNTB diagnosis.
Conclusions:
- Puncture cytology is crucial for diagnosing diverse causes of enlarged lymph nodes, including infections and malignancies.
- Lymph node tuberculosis presents a diagnostic challenge, particularly in adult women, with limited utility of the Mantoux test.
- Malignant tumors are a significant cause of enlarged parotid and supraclavicular lymph nodes.
Abstract:
In 1999-2000, puncture cytological diagnosis was made in 134 patients. Enlarged lymph nodes (LN) were detected in 114 patients. The enlargement occurred due to nonspecific inflammation (38.6%), common hyperplasia (26.3%), tuberculosis (18.5%), metastases of cancer (14.9%), sarcoidosis (1.7%). LN tuberculosis was a frequent finding in adult women--in 2/3 of all tuberculosis cases. In children it was rare (3.7%). LN enlargement was caused by cancer in divided by of the cases. LN tuberculosis was detected in adults 5 times more frequently than in children. M. tuberculosis were detected bacterioscopically in tuberculous lymph nodes puncture biopsies only in 6 examinees (28.6%). The Mantoux test appeared unreliable in diagnosis of peripheral LN tuberculosis. Tuberculous LN located under the mandible or on the neck. Specific non-tuberculous processes, primarily malignant tumors, were revealed in enlarged parotid and supraclavicular LN in half of the cases.
