Chaves, Vanessa and Nogueira, Fernando and Rosa, Gilberto Pires da and Tavares, Sofia and Ferreira, Inês and Oliveira Monteiro, Ana and Ferreira, Ester (2019) Cervical Lymphadenopathy in a Nonagenarian Woman: What to Think? European Journal of Case Reports in Internal Medicine, 6 (12). ISSN 2284-2594
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Abstract
Tuberculosis remains a worldwide public health problem. Cervical tuberculous lymphadenitis (TBL) or scrofula is the most common form of extrapulmonary tuberculosis, affecting the cervical lymph nodes. We report the case of a 93-year-old woman presenting with cervical adenopathies with 3 months duration. Fine needle aspiration (FNA) biopsy yielded a noncaseous granulomatous process, but was negative for Mycobacterium tuberculosis (MT). As the adenopathies had grown, an excisional biopsy was performed. An extensive study of infectious aetiologies was performed, including for MT, with a negative outcome. Owing to the persistence of cervical lymphadenitis with caseous granulomas, a diagnosis of TBL was strongly suspected and presumptive treatment was initiated. Afterwards, diagnostic confirmation was obtained by isolation of MT in the lymph node culture. The patient presented a favourable clinical outcome. This case highlights that a high index of suspicion is essential for the diagnosis of TBL, especially in the elderly, and emphasizes the importance of pursuing diagnostic confirmation, in which FNA and excisional biopsy plays a key role.
| Item Type: | Article |
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| Uncontrolled Keywords: | Cervical lymphadenopathy, cervical tuberculous lymphadenitis, fine needle aspiration biopsy, excisional biopsy, differential diagnosis |
| Subjects: | 600 Tecnologia - Scienze applicate > 610 Medicina e salute (Classificare qui la tecnologia dei servizi medici) > 616 Malattie (classificare qui la Clinica medica, la medicina basata sull'evidenza, la Medicina interna, la Medicina sperimentale) |
| Depositing User: | Chiara D'Arpa |
| Date Deposited: | 19 Nov 2020 09:40 |
| Last Modified: | 19 Nov 2020 09:40 |
| URI: | http://eprints.bice.rm.cnr.it/id/eprint/19629 |
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