Tuberculous lymphadenopathy

Case contributed by Dr Ahmed Samir

Presentation

Fever, anorexia, and weight loss

Patient Data

Age: 25 years
Gender: Male
CT
  • multiple extensive lymph nodes showing central necrosis seen in cervical groups bilaterally, right axillary, mediastinal, porta hepatis, splenic hilum, and mesenteric groups

  • mild left pleural effusion with basal lung consolidation, mild thickening of the left oblique fissure, multiple small lung nodules bilaterally

  • small pleural-based right lower atelectatic bands

Case Discussion

Multiple areas of extensive cervical, mediastinal, axillary, and abdominal lymphadenopathy with low density (necrotic) centers. Together with the demographics and presentation of the patient, the diagnosis of tuberculous adenitis is most likely.

Cervical lymph node biopsy was done.

 

Histopathology

Gross description

Received in formalin in a single container labeled 'cervical LN', is a single tissue fragment measuring 1.2 cm. All taken in 1 cassette.

Microscopy

The section shows fibrous tissue with a caseous necrotizing granuloma and plasma cell infiltration.

Special stain: ZN and PAS did not show fungus or bacilli.

Diagnosis: Lymph node biopsy (cervical): Features compatible with TB infection.

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Case information

rID: 61994
Published: 30th Jul 2018
Last edited: 14th Aug 2019
System: Head & Neck
Inclusion in quiz mode: Included

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