A study on incidence and etiology of cervical lymphadenopathy in community
Keywords:Tuberculosis, Lymph node, Pulmonary, Lymphoma, HIV, Biopsy, FNAC
Background: The etiologies for cervical lymphadenopathy fall under a wide range spectrum and usually, history and physical examination alone may lead to a diagnosis. Posterior cervical LAP may occur with Epstein-Barr virus (EBV) infection, tuberculosis, lymphoma, or head and neck malignancy (either lymphomas or metastatic squamous cell carcinoma). However, a stepwise methodological approach to LAP can lead to an accurate diagnosis with minimal discomfort to the patient and also less time-consuming for the clinician.
Methods: In this series, 320 cases were studied with taking a detailed clinical history, physical examination, and investigations. After a physical examination and reaching a clinical diagnosis, confirmation was done by fine needle aspiration cytology (FNAC) and biopsy.
Results: Incidence of tuberculous LAP is much higher in lower socioeconomic class groups people versus middle or higher socioeconomic class groups. Incidence of tuberculous LAP is higher in urban areas compared to rural areas due to overcrowding, and poor sanitation.
Conclusions: Tuberculosis is a potentially serious infectious disease, one of the commonest diseases affecting lymph nodes. It is curable with anti-tubercular drugs if administered as per the accepted regimen.
Fontanilla JM, Barnes A, von Reyn CF. Current diagnosis and management of peripheral tuberculous lymphadenitis. Clin Infect Dis. 2011;53:555.
Dandapat MC, Mishra BM, Dash SP, Kar PK. Peripheral lymph node tuberculosis: a review of 80 cases. Br J Surg. 1990;77:911.
Narang P, Narang R, Narang R, Mendiratta DK, Sharma SM, Tyagi NK. Prevalence of tuberculous lymphadenitis in children in Wardha district, Maharashtra State, India. Int J Tuberc Lung Dis. 2005;9:188.
Alami NN, Yuen CM, Miramontes R, Pratt R, Price SF, Navin TR; Centers for Disease Control and Prevention (CDC). Trends in tuberculosis - United States, 2013. MMWR Morb Mortal Wkly Rep. 2014;63:229.
Rieder HL, Snider DE Jr, Cauthen GM. Extrapulmonary tuberculosis in the United States. Am Rev Respir Dis. 1990;141:347.
Peto HM, Pratt RH, Harrington TA, LoBue PA, Armstrong LR. Epidemiology of extrapulmonary tuberculosis in the United States, 1993-2006. Clin Infect Dis. 2009;49:1350.
Mathiasen VD, Eiset AH, Andersen PH, Wejse C, Lillebaek T. Epidemiology of tuberculous lymphadenitis in Denmark: A nationwide register-based study. PLoS One. 2019;14:e0221232.
Hill AR, Premkumar S, Brustein S, Vaidya K, Powell S, Li PW, Suster B. Disseminated tuberculosis in the acquired immunodeficiency syndrome era. Am Rev Respir Dis. 1991;144:1164.
Geldmacher H, Taube C, Kroeger C, Magnussen H, Kirsten DK. Assessment of lymph node tuberculosis in northern Germany: a clinical review. Chest. 2002;121:1177.
Fain O, Lortholary O, Djouab M, Amoura I, Babinet P, Beaudreuil J, et al. Lymph node tuberculosis in the suburbs of Paris: 59 cases in adults not infected by the human immunodeficiency virus. Int J Tuberc Lung Dis. 1999;3:162.
Wark P, Goldberg H, Ferson M, McKenzie D, Lau E, Rivas K. Mycobacterial lymphadenitis in eastern Sydney. Aust N Z J Med. 1998;28:453.
Castro DJ, Hoover L, Castro DJ, Zuckerbraun L. Cervical mycobacterial lymphadenitis. Medical vs surgical management. Arch Otolaryngol. 1985;111:816.
Artenstein AW, Kim JH, Williams WJ, Chung RC. Isolated peripheral tuberculous lymphadenitis in adults: current clinical and diagnostic issues. Clin Infect Dis. 1995;20:876.
Thompson MM, Underwood MJ, Sayers RD, Dookeran KA, Bell PR. Peripheral tuberculous lymphadenopathy: a review of 67 cases. Br J Surg. 1992;79:763.
Perlman DC, D'Amico R, Salomon N. Mycobacterial Infections of the Head and Neck. Curr Infect Dis Rep. 2001;3:233.
Mert A, Tabak F, Ozaras R, Tahan V, Oztürk R, Aktuğlu Y. Tuberculous lymphadenopathy in adults: a review of 35 cases. Acta Chir Belg. 2002;102:118.
Shriner KA, Mathisen GE, Goetz MB. Comparison of mycobacterial lymphadenitis among persons infected with human immunodeficiency virus and seronegative controls. Clin Infect Dis. 1992;15:601.
Atomiya AN, Uip DE, Leite OH. Evaluation of disease patterns, treatment and prognosis of tuberculosis in AIDS patient. Braz J Infect Dis. 2002;6:29.
Lee MP, Chan JW, Ng KK, Li PC. Clinical manifestations of tuberculosis in HIV-infected patients. Respirology. 2000;5:423.
Jones BE, Young SM, Antoniskis D, Davidson PT, Kramer F, Barnes PF. Relationship of the manifestations of tuberculosis to CD4 cell counts in patients with human immunodeficiency virus infection. Am Rev Respir Dis. 1993;148:1292.
Shikhani AH, Hadi UM, Mufarrij AA, Zaytoun GM. Mycobacterial cervical lymphadenitis. Ear Nose Throat J. 1989;68:660.
Mitra S, Dey P. Fine-needle aspiration and core biopsy in the diagnosis of breast lesions: A comparison and review of the literature. Cytojournal. 2016;13:18.
Winter JR, Taylor GS, Thomas OG, Jackson C, Lewis JEA, Stagg HR. Predictors of Epstein-Barr virus serostatus in young people in England. BMC Infect Dis. 2019;19(1):1007.
Richner S, Laifer G. Peripheral lymphadenopathy in immunocompetent Adults. Swiss Med Wkly. 2010;140:98-104.
Metzger ML, Mauz-Körholz C. Epidemiology, outcome, targeted agents and immunotherapy in adolescent and young adult non-Hodgkin and Hodgkin lymphoma. Br J Haematol. 2019;185(6):1142-57.
Thandra KC, Barsouk A, Saginala K, Padala SA, Barsouk A, Rawla P. Epidemiology of Non-Hodgkin's Lymphoma. Med Sci (Basel). 2021;9(1):5.