FREQUENCY OF TUBERCULOSIS IN CERVICAL LYMPHADENOPATHY

Objective: To determine the proportion of tuberculosis in patients presenting with cervical lymphadenopathy. Methodology: This descriptive study was carried out from June 2007 to May 2010 in the Ear, Nose and Throat department, District Headquarters Hospital (DHQ) Lakki Marwat. Patients with enlarged cervical lymph nodes for more than six weeks duration, of either sex and of any age were approached for inclusion into the study. Out of 110, 20 were excluded as the cause was found to be acute inflammation in the throat. Ninety patients were included in the study. After a detailed history and clinical examination, excisional biopsy of the lymph nodes was performed in all these patients. Results: Of 90 patients, 62 (68.9%) were males and the majority of patients had ages from 12-40 years. Tuberculous cervical lymphadenopathy was diagnosed in 67(74.5%) patients, reactive hyperplasia in 10 (11.1%), metastasis to cervical lymph nodes in 6 (6.7%), lymphoma in 4 (4.4%) and Kikuchie’s lymphadenitis in 3 (3.3 %) cases. About 72 (80%) of the patients had involvement of multiple lymph nodes while 18 (20%) had single swelling. Sixty three (70%) of the patients had matted lymph nodes whereas discrete lymph nodes were found in only 18 (20%) cases. Conclusion: Tuberculosis is the commonest cause of cervical lymphadenopathy, with the majority of these patients having multiple lymph node involvement. Disease is more common in the younger age group and the group of lymph nodes most frequently affected is posterior cervical group.