EXTRAPULMONARY CERVICAL TUBERCULOUS LYMPHADENOPATHY: MORE COMMON THAN WE THINK — A TERTIARY CARE HOSPITAL EXPERIENCE

Background: TB can affect virtually any organ of the body and can be pulmonary or extrapulmonary. Extrapulmonary tuberculosis accounts for 20% of all TB cases with lymph nodes being the most common site of occurrence. The objective of this study was to determine the frequency of extrapulmonary tuberculosis in patients presenting with cervical lymphadenopathy. Material Methods: This was a descriptive study conducted at Department of Thoracic Surgery, Ojha Institute of Chest Diseases, Dow University of Health Sciences, Karachi, Pakistan from December 2012 to April 2015. All patients who presented with cervical lymphadenopathy which was not secondary to acute ear, nose, throat or dental infection or enlarged thyroid swellings/mass were included in the study. After informed consent, history, physical examination, ultrasonography of neck and FNAC were performed in all patients. Those patients in which FNAC failed to confirm the diagnosis, underwent lymph node biopsy Results: A total of 491 patients, including 322(65.5%) females and 169(33.5%) males were studied. The mean age of patients was 33.8 years. All the patients complained of neck swelling followed by fever in 248(50.4%) and cough in 172(35.1%). Regarding the mode of diagnosis 310(63.2%) patients were diagnosed on FNAC, 112(22.8%) on excisional and 69(14%) on incisional biopsy. Among these 363(74.1%) patients were diagnosed with tuberculosis. Reactive hyperplasia was the next common diagnosis in 50(10.3%) patients. Conclusion: Tuberculosis is the commonest cause of cervical lymphadenopathy in developing countries and should be investigated in every case of cervical lymphadenopathy with FNAC and/or biopsy