The aim of this study is to estimate the incidence of cervical node tuberculosis (TB) in an urban middle class population and to describe an effective protocol for management of cervical lymphadenopathy. The present study is a prospective observational study conducted over two years (2007)(2008)(2009)) in a community hospital in Mumbai, India. All adults (age C14 years) presenting with cervical lymphadenopathy, not resolving were included and their details of history and examination were noted. All patients were subjected to fine needle aspiration cytology (FNAC) and biopsy was done selectively as indicated. The response at 1, 3 and 6 months of starting anti tuberculous treatment (ATT) were noted. A total of 191 patients were included in this study. The mean age was 41 years and male to female ratio was 1:1.1 in patients with cervical lymphadenopathy. A history of contact with a patient of TB was the most significantly associated history seen in patients diagnosed to have TB of cervical nodes (p \ 0.001). TB (38.7%) followed by reactive nodes (37.6%) were the most common etiologies. A 90.6% response rate was seen in patients taking 6 months ATT for cervical node TB. The incidence of adult (C14 years) cervical node TB was 52/100,000 people in an urban middle class community in Mumbai. A single swelling in the neck without other associated symptoms or signs was the commonest mode of presentation of TB of the neck nodes. A history of contact with TB, demonstrated an association with the final diagnosis of tuberculous lymphadenopathy.

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Esophageal cancer is a morbid disease with a grim prognosis. The outcomes of treatment even in non-metastatic disease undergoing potentially curative surgery are poor with 5-year survival ranging from 20 to 35 %. Several multimodality treatment options have been investigated in well-conducted randomised trials and meta-analyses evaluating both neoadjuvant and adjuvant therapies. However, there is still lack of uniform practice in the management of operable esophageal cancer. We review the current evidence for multimodality treatment of esophageal cancer, critically analysing the evidence supporting the use of each strategy, the pros and cons of each approach and discuss our approach in management. Neoadjuvant chemotherapy or chemoradiotherapy are currently the standard of care in localised esophageal cancer.