A clinical study of tuberculous cervical lymphadenopathy: surgeon’s perspectives

Abstract

Background: Cervical lymphadenopathy is common in this country. There are many causes of cervical lymphadenopathy like, malignancies, infections, autoimmune disorders, iatrogenic, and other miscellaneous conditions. There are more chances of wrong clinical diagnosis in case  of lymphadenopathy than any other diseases. The present study was planned with the objective to study the clinical presentation of tuberculous cervical lymphadenopathy.Methods: A prospective, cross-sectional study was undertaken with inclusion of all cases of cervical lymphadenopathy attending the department of general surgery. The patients with cervical lymphadenopathy irrespective of age, sex, caste, religion, socio-economic status, duration and severity of illness were included in this study. The patients with primary malignancy, patients with clinical features of suspected malignancy like obvious growth or ulcer in head and neck region and pregnant women were excluded from the study.Results: Total 130 patients presented with cervical lymphadenopathy during the study duration. Infective etiology was the commonest (55, 42.31%) cause for the cervical lymphadenopathy followed by TB (50, 38.46%). The commonest age group affected by tuberculous cervical lymphadenopathy (TCL) was 20-35 years. The females (29, 58.00%) were more affected with TCL as compared to males (21, 42.00%). A majority of the patients (45, 90.00%) had unilateral TCL. Commonly involved lymph node group was level V (26, 52.00%). Other than excision biopsy (12 patients), no other type of surgery was needed in patients.Conclusions: Though, anti-tuberculous chemotherapy is the mainstay of treatment for TCL, surgical treatment is more useful in selected cases. In this regard, early diagnosis and treatment are critical in lowering the overall prevalence. Therefore, it is important that surgeons are aware of tuberculosis in the head and neck region.