Tubercular cervical adenitis: clinicopathologic analysis of 180 cases.

OBJECTIVE: To analyze the clinical presentations, laboratory investigation results, and histopathologic evaluation of tubercular cervical adenitis (TCA) in our population.

DESIGN: Prospective study.

SETTING: Tertiary health care centre.

PATIENTS AND METHODS: We studied 180 patients with TCA who were managed in the Department of Otolaryngology between December 2004 and June 2007.

RESULTS: There were 76 male patients (42%) and 104 females (58%), with ages ranging from 5 to 58 years. All patients presented with single or multiple neck swellings. Constitutional symptoms such as fever were present in 52 patients (29%), whereas cough, weight loss, and reduced appetite were seen in 40 patients (22%). Forty-seven patients (26%) had bilateral lymph node involvement. Only 23 patients (13%) had chest radiographs suggestive of pulmonary tuberculosis. Fine-needle aspirates from 168 patients (93%) showed granulomas with caseating necrosis. However, acid-fast bacilli were seen in only 45 (25%) aspirate smears. Twelve patents (7%) required a lymph node biopsy to confirm the diagnosis.

CONCLUSION: TCA usually presents with multiple lymph node involvement without the constitutional signs and symptoms of tuberculosis. The diagnosis is based on a high index of clinical suspicion coupled with laboratory and pathologic investigations.