Tuberculous Cervical Lymphadenopathy

Abstract

Tuberculous cervical lymphadenopathy is a common surgical problem and is frequently encountered in ENT practice. A study of 102 patients with tuberculous cervical lymphadenoapthy (TCL) was carried out over a four years period from January 1997 to January 2001 at the ENT department of DHQ Hospital, Daggar NWFP, 45000 patients visited this department during this period. The prevalence of tuberculous cervical lymphadenopathy was 51% amongst the neck swellings excluding thyroid swelling and 0.2%  (two patients per one thousand) amongst the patients attending ENT OPD and 0.02% (two patients per ten thousand) amongst the general outdoor patients visiting this hospital. The third decade wa the most vulnerable age group with female preponderane i.e. female to male ratio 5:1. Teh common presentations were neck swelling 100%, weight loss 63%, fever 41% and anaemia 34%. Only 2 cases of TCL were associated with pulmonary tuberculosis. Mantoux test was positive in 86.7%. Maximum  number of patients were from low socioeconomic class. Teh BCG vaccination had significant protective role (19.61% were vaccinatee and 82.39% were non vaccinated). Histopathology of cervical lymph nodes revealed caseation necrosis in 90.19% of cases.