Tuberculous Cervical Lymphadenitis, Treatment and Outcome

Woo, Joo Hyun; Yoon, Jin Ho; Lim, Chae Young; Kim, Dong Young

Abstract

BACKGROUND AND OBJECTIVES: Tuberculous cervical lymphadenitis is a clinically common cervical inflammatory disease. But there are controversies in the management in spite of high prevalence. The aim of this study was to investigate proper treatment modality, such as antituberculous chemotherapy and surgery.
SUBJECTS AND METHOD
The study was based on a retrospective chart review in 65 patients with tuberculous cervical lymphadenitis who were treated between January 2001 and May 2005 at Gachon University Gil Medical Center, Incheon, Korea. We have studied clinical manifestations, characteristics of the neck masses, diagnostic approach, radiologic finding, treatment modality, treatment response, and prognosis.
RESULTS
Females were more affected, by about three fold, than males and the prevalence rate was higher in younger patients ranging from 20 to 30. The diagnosis was made over 89% with the initial tests such as FNAB, AFB stain and tuberculous PCR. The successful treatment rate just with anti-tuberculous medication was 90.6%. Especially, in the patients with abscess formation, treatment was successful in 90% only with anti-tuberculous medication. Seventeen cases were treated with medication and surgical management. These patients underwent selective neck dissection or mass excision to remove the entire lesion and there were no recurrence.
CONCLUSION
Tuberculous lymphadenitis can be managed well just with anti-tuberculous medication. But, if local symptoms get worse even though the patient is under medical treatment, early surgical treatment is needed. The important thing is to remove the entire lesion when the surgical treatment must be taken.