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Objective: Tuberculous lymphadenitis (TL) is the most frequent presentation of extrapulmonary tuberculosis. The purpose of this study is to review many aspects of the patients with TL, and to determine whether TL is a generalized disease.
Methods: The files of the cases diagnosed over a period of 20 months in our hospital were reviewed clinically, radiologically, pathologically, and regarding treatment and outcome. The diagnosis has been established by the presence of caseating granulomas or bacteriologic confirmation by smear or culture, and a clinical diagnosis of tuberculosis (TB) with response to specific antituberculous therapy. Anatomic distribution of involved lymph nodes, extrapulmonary involvement other than lymphadenitis, and pulmonary TB have also been assessed during the diagnostic work-up for TL.
Results: Mean age was 34.4±14.2, 16 patients were female, 5 were male. In 15 (71.4%) of the cases, lymphadenitis was determined in only one location, and in 6 (28.6%) in more than one location. Pulmonary tuberculosis was detected in 9 (42.9%) of the cases while other extrapulmonary tuberculosis was detected in 5 (23.8%) of the cases (two cases of cutaneous, two of peritoneal, and one of colonic TB).
In 14 (66.7%) of the cases there was either generalized lymphadenitis or localized lymph node involvement together with pulmonary tuberculosis or other extrapulmonary tuberculosis. TL in a single location was detected in 7 (33-3%) patients with no pulmonary or extrapulmonary tuberculosis. Concerning the number of patients with TL, no significant difference was found between localized and generalized involvement (p=0.397).
Conclusion: Our data, though not statistically significant, suggest that TL is not a localized disease.