Extrapulmonary tuberculosis in patients with cervical lymphadenopathy

Objective: To determine the frequency of tuberculous lymphadenitis in patients with cervical lymphadenopathy, and to determine the association of tuberculous lymphadenitis with body mass index. Methods: The descriptive cross-sectional study was conducted at the Department of ear, nose, throat (ENT), Head and Neck Surgery, Post Graduate Medical Institute, Lady Reading Hospital Peshawar, from March, 2010 to February 2011 included 101 patients with enlarged cervical lymph nodes fulfilling the inclusion criteria. Tuberculosis was diagnosed in cervical lymph nodes by fine needle aspiration and open biopsies where needed. Data was collected on a pre-designed proforma and was analysed by SPSS 11. Results: The study comprised 101 cases with cervical lymphadenopathy: 63 (62.37%) females and 38(37.62%) males, with a female:male ratio of 1.65:1. The age of the patients ranged from 03-67 years with a mean of 32.56±13.49 years. Most of patients (n=77; 76.23%) were from lower socioeconomic group and had low body mass index. The main complaint of these patients was fever (n=35; 34.65%). Extrapulmonary tuberculosis was the commonest diagnosis in cervical lymphadenopathy accounting for 76(75.24%), while reactive hyperplastic lymphadenopathy (n=11; 10.89%) was the next common finding. Rare diseases diagnosed in cervical lymph nodes were Hodgkin s disease 2(1.98%), Non-Hodgkin s lymphoma 2(1.98%), and 1(0.99%) case of Kikuchi s disease. The tuberculous cervical lymphadenopathy was significantly associated with low body mass index (p 0.0001). Conclusion: Tuberculous cervical lymphadenopathy is a common disease in our society. It is more common in young poor females with low body mass index. Therefore, it is important to have a high index of suspicion for diagnosing tubercular lymphadenopathy.