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Clinico-Demographic Characteristics of tuberculous lymphadenitis: Experience of 50 Cases in Bangladesh

Journal of Tuberculosis Research 2016年第4期4卷 220-226页

作者： Mohammad Mahmudul Huda Mohammad Taufiq Md. Abdullah Yusuf Mohammad Rezwanur Rahman Ferdousy Begum Mohammed Kamal Department of Pathology Dhaka National Medical College Dhaka Bangladesh Square Hospital Dhaka Bangladesh Department of Microbiology National Institute of Neurosciences & Hospital Dhaka Bangladesh Department of Biochemistry Delta Medical College Dhaka Bangladesh Department of Pathology Banghabandhu Sheikh Mujib Medical University Dhaka Bangladesh

Background: Clinical and demographic features are important for the tuberculous lymphadenitis patients for treatment. Objective: The purpose of the present study was to see the clinical and demographic features of tuberculous lymphadenitis patients. Methodology: This cross-sectional study was done at the Department of Pathology at Banghabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from January 2009 to March 2011 for a period of nearly two years. All the patients, irrespective of age and sex with the clinical features, suggestive of tuberculous lymphadenitis and later on, proved to be the same histologically, were selected for the study purposively. Relevant information was recorded in a prescribed data sheet and histomorphological findings were recorded accordingly. In cases where fresh specimen was available, caseous portion of lymph node was sent for culture. Fite Faraco staining was also done on lymph node sections in all cases. Result: A total number of 50 tuberculous lymphadenitis patients were recruited for this study. Among this study population, the age of cases ranged from 12 years to 65 years with a mean age of 26.22 ± 2.52 years. Male and female ratio was 1:1.38. Besides lymphadenopathy, 45 patients had low grade fever;32 patients had weight loss and 18 patients had cough. Among 50 cases of lymph node tuberculosis cervical lymphadenopathy was 41 (82.0%) cases;6 (12.0%) cases had supraclavicular lymphadenopathy;2 (4.0%) cases had inguinal lymphadenopathy and 1 (2.0%) had axillary lymphadenopathy. The mean duration of presentation of lymphadenopathy with standard deviation was 7.06 ± 1.6 months. Thirty eight patients (76.0%) had lymphadenopathy for less than 12 months. Conclusion: In conclusion, young age group people are most commonly affected by tuberculous lymphadenitis with the predominance of female and most of them are presented with low grade fever and weight loss.

关键词： tuberculous lymphadenitis Tuberculosis Lymph Nodes Clinical Features

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Comparison of Histological, Microbiological, and Molecular Methods in Diagnosis of Patients with TBLN Having Different Anti-TB Treatment Background

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Biomedical and Environmental Sciences 2017年第6期30卷 418-425页

作者： CHE Nan Ying HUANG Shao Jun MA Yan HAN Yi LIU Zi Chen ZHANG Chen MU Jing ZHAO Dan QU Yang ZHANG Hai Qing LIU Zhi Dong XU Shao Fa Department of Pathology Beijing Tuberculosis & Thoracic Tumor Research Institute Beijing Chest Hospital Capital Medical University Beijing 101149 China Department of Thoracic Surgery The affiliated hospital of Inner Mongolia Medical University Hohhot 010110 Inner Mongolia China Clinical Center Beijing Tuberculosis & Thoracic Tumor Research Institute Beijing Chest Hospital Capital Medical University Beo'ing 101149 China Department of Thoracic Surgery Beijing Tuberculosis & Thoracic Tumor Research Institute Beijing Chest Hospital Capital Medical University Beijing 101149 China

Objective The influence of anti-tuberculosis （TB） treatment history on tuberculous lymphadenitis （TBLN） diagnosis is unclear. Therefore, this study aims to evaluate the diagnostic methods, including histology, microbiology, and molecular tests, used for TBLN. Methods In this study, suspected patients with TBLN and having different anti-T8 treatment background were enrolled. All the samples were tested simultaneously by histology, ZiehI-Neelsen （ZN） staining, mycobacterial culture （culture）, Xpert MTB/RIF （xpert）, real-time PCR, and high-resolution melting curve PCR （HRM）. Thereafter, the performance of these methods on samples with different anti-TB treatment background was assessed. Results In our study, 89 patients were prospectively included 82 patients with TBLN and 7 with other diseases. The overall sensitivities of Xpert, real-time PCR, histology, ZN staining, and culture were 86.6%, 69.5%, 58.5%, 43.9%, and 22.0%, respectively. The anti-TB treatment history revealed dramatic influences on the sensitivity of culture （P 〈 0.0001）. In fact, the treatment that lasted over 3 months also influenced the sensitivity of Xpert （P 〈 0.05）. However, the treatment history did not affect the performance of remaining tests （P 〉 0.05）. For rifampicin drug susceptibility test （DST）, the anti-T8 treatment showed only significant influence on the success rate of culture DST （P = 0.001）, but not on those of Xpert and HRM tests （P 〉 0.05）. Conclusion Other tests as welt as culture should be considered for patients with TBLN having retreatment history or over 1-month treatment to avoid false negative results.

关键词： tuberculous lymphadenitis Mycobacterial culture Molecular test Anti-TB treatment Drugresistance

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Two Cases of Tuberculosis Manifesting as Cutaneous Solitary Mass in Patients with Adult T-Cell Leukemia/Lymphoma

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Journal of Tuberculosis Research 2016年第3期4卷 134-139页

作者： Monji Koga Masaki Fujita Shinichi Imafuku Department of Dermatology Faculty of Medicine Fukuoka University Fukuoka Japan Department of Respiratory Medicine Fukuoka University School of Medicine Fukuoka Japan

Tuberculosis (TB) is a major public health problem worldwide and a large number of fatal cases are still reported. Immunocompetent individuals are naturally susceptible to TB, and immunocompromised patients have a greater risk of infection. Although patients with adult T-cell leukemia/lymphoma (ATL) are in an immunosuppressed condition, there is only one reported case of TB accompanied with ATL in the English- language literature in the field of dermatology. Here, we report two patients with chronic-type ATL infected with TB manifesting as cutaneous solitary masses. Case 1 was a 58-year-old woman diagnosed with lumbar abscess with pulmonary TB. Case 2 was an 84-year-old woman diagnosed with tuberculous lymphadenitis in the left cervical region. It is important to raise the differential diagnosis of TB and perform tissue culture for acid-fast bacilli as well as Interferon-Gamma release assay test when dermatologists encounter mass lesions in patients with ATL.

关键词： Tuberculosis tuberculous lymphadenitis Immunosuppression Adult T-Cell Leukemia/Lymphoma Regulatory T-Cell

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