文章基本信息

标题：Cervical Lymphadenopathy—Pitfalls of Blind Antitubercular Treatment
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作者：Sudipta Pandit ; Sabyasachi Choudhury ; Anirban Das 等
期刊名称：The Journal of Health, Population and Nutrition
印刷版ISSN：1606-0997
电子版ISSN：2072-1315
出版年度：2014
卷号：32
期号：1
页码：155-159
语种：English
出版社：International Centre for Diarrhoeal Disease Research Bangladesh
摘要：Tuberculosis (TB) is the most common cause of cervical lymphadenopathy in the TB-endemic zone, like India but it can also mimic other diseases. Four cases of cervical lymphadenopathy presented to us as initial treatment failure after completion of six months of antitubercular drugs (ATD), including rifampicin, isoniazid, pyrazinamide, and ethambutol. All were diagnosed as having tuberculosis either by fine needle aspiration cytology or clinically from outside our institution. In one case, tuberculosis was the final diagnosis but, unfortunately, it was multidrug-resistant. In other three cases, Hodgkin disease, Non-Hodgkin lymphoma, and Kikuchi's disease were the diagnoses. In resource-poor countries, like India, which is also a TB-endemic zone, TB should be the first diagnosis in all cases of chronic cervical lymphadenopathy, based on clinical and/or cytological evidences. So, they were correctly advised antitubercular therapy (ATT) initially. Sometimes, TB mimics other aetiologies where apparent initial improvement with ATT finally results in treatment failure. Hence, investigations for microbiological and histopathological diagnosis are warranted, depending on the resources and feasibility. If these tests are not routinely available, the patients should be under close monitoring so that lymphoma, drug-resistant TB, or other aetiologies of cervical lymphadenopathy are not missed. Patients with cervical lymphadenopathy rarely presents acutely; so, a physician can take the opportunity of histopathological study of lymphnode tissue. Key words: Cervical lymphadenopathy, Excision biopsy, Hodgkin disease, Kikuchi's disease, Non-Hodgkin lymphoma, Tuberculosis
关键词：Cervical lymphadenopathy; Excision biopsy; Hodgkin disease; Kikuchi's disease; Non-Hodgkin lymphoma; Tuberculosis