Lymph node tuberculosis – The ENT surgeon approach in four cases

Abstract

BACKGROUND. Lymph node tuberculosis is a pathology with an increasing incidence and prevalence in middle income countries. MATERIAL AND METHODS. We present a series of 4 cases with cervical lymph node tuberculosis. We review current principles of diagnosis and treatment from the perspective of the ENT surgeon in a tertiary university clinic. RESULTS. In each case we underline diagnosis difficulties and treatment options. These cases presented management difficulties due to associated morbidities. All cases underwent surgical excision of the afflicted lymph nodes with subsequent microscopic confirmation of tuberculosis. We illustrate key concepts leading to the microscopy diagnosis of lymph node tuberculosis. CONCLUSION. There are various surgical incidents and accidents that the young surgeon must be aware of when approaching neck tuberculous lymph nodes. Further referral of the patient for long-term tuberculosis treatment is mandatory. All patients were supervised for a minimum of 1 year after the initial diagnosis and treatment with no sign of recurrence. A close cooperation between the ENT surgeon, the infectious disease specialist and the pathologist is the key to an optimum approach to lymph node tuberculosis at the head and neck level.