Origin of Peripheral Tuberculous Lymphadenitis in Childhood

Miller, F. J. W.; Cashman, J.M.

doi:10.1016/s0140-6736(58)91030-4

Cited by 22 publications

(7 citation statements)

References 5 publications

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“…It is a common manifestation of extrapulmonary TB in the developed world and accounts for approximately half of the annually reported cases of extrapulmonary disease in Santa Clara County 72,73 . The pathogenesis of this disease has been the subject of much debate as it is not clear if TB lymphadenitis represents local disease or is part of a generalized process 40,45,57,60,80,88,90 . While most cases in adults reflect reactivation or postprimary TB, there are reports in the literature suggesting that the enlargement of the nodes in the head and neck are representative of primary local infection of the tonsils or nasopharynx 57,80,86,88,93 .…”

Section: Discussionmentioning

confidence: 99%

Peripheral Tuberculous Lymphadenitis

2005

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We reviewed 106 patients referred to our institution for treatment of peripheral tuberculous adenitis to establish the epidemiologic, clinical, and pathologic manifestations of this disease. Tuberculous lymphadenitis occurred predominantly in young, foreign-born women a mean of 5 years after arrival in the United States. Tuberculin skin tests were positive in 94% of cases. Lymphadenopathy occurred most frequently in the neck (57%) or supraclavicular area (26%) and involved 1-3 nodes. Forty (38%) patients had an abnormal chest radiograph consistent with granulomatous infection. Culture-positive pulmonary tuberculosis was diagnosed in 41% of those patients with abnormal chest radiographs. Fine needle aspiration was an essential step in the evaluation and diagnosis of tuberculous lymphadenitis. Granulomas were seen in 61% of fine needle aspirates and 88% of surgical biopsies. Positive cultures for Mycobacterium tuberculosis were obtained from 62% of fine needle aspirate samples and 71% of excisional biopsies. The presence of necrosis and/or neutrophilic inflammation in tissue samples correlated with culture positivity. Given the high yield of positive cultures from fine needle aspirates, surgery was rarely indicated as an initial step in immunocompetent adults. In this cohort, 101 patients received a final diagnosis of peripheral tuberculous lymphadenitis. Eighty-two percent received their entire therapy under direct observation, and response to antituberculous therapy was uniformly successful. Paradoxical expansion of adenopathy was seen in 20% of all patients and was more commonly noted in human immunodeficiency virus-seropositive patients. We present a diagnostic algorithm based on our experience.

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Section: Discussionmentioning

confidence: 99%

Peripheral Tuberculous Lymphadenitis

2005

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“…Consumption of raw contaminated cows’ milk has been thought to be the usual cause. Apart from tonsillar infection, concurrent lesions of the draining pharyngeal and cervical lymph nodes (peripheral lymphadenitis) are often present 31 , 32 . In people with cervical lymphadenitis, the prevalence of confirmed tonsillar infection has been found to vary between 24 and 50%, 33 , 34 , 35 , 36 with the tonsillar infection usually asymptomatic 29 .…”

Section: Mycobacteria and Maltmentioning

confidence: 99%

Mucosa‐associated lymphoid tissues as sites for uptake, carriage and excretion of tubercle bacilli and other pathogenic mycobacteria

Lugton

1999

Immunol Cell Biol

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Summary Pathogenic mycobacteria, including those that cause tuberculosis and paratuberculosis, cross mucosal barriers by endocytosis within mucosal lymphoepithelial sites. These entry sites commonly include oropharyngeal and nasopharyngeal tonsils and Peyer's patches. Bacilli discharged at the basolateral surfaces of engulfing epithelial M cells are taken up by professional antigen-presenting cells associated with T lymphocytes of the parafollicular area. Dendritic cells and macrophages in these sites allow mycobacterial replication, due to the permissive immunological environment in lymphoepithelial tissues. Abrogation of local delayed-type hypersensitivity reactions generally ensures continuing integrity and function of these tissues. Phagocytes containing intracellular mycobacteria disseminate infection to other parts of the body and also probably migrate back onto the mucosal surface to shed bacilli.

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“…Wilmot, James & Reilly (1957) found only five cases of lymphadenopathy at this site out of seventy-one patients in whom only one group of glands was affected.…”

Section: Sites Of Diseasementioning

confidence: 86%

“…Miller & Cashman (1958) in their study of 159 children concluded that this was the case in this age-group and that the tonsils were the commonest site of infection in the case of cervical lymphadenopathy. Where other nodes were affected, e.g.…”

Section: Sites Of Diseasementioning

confidence: 93%

Tuberculous cervical lymphadenopathy

Newcombe

1971

Postgraduate Medical Journal

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Summary Forty-five cases of tuberculous cervical lymphadenopathy have been treated by a combination of early surgery and long-term chemotherapy. The majority of these patients have been immigrants of Asiatic origin. The posterior cervical group of nodes has been the most commonly involved. The site of primary infection was not identified. Histological examination of biopsy material proved the most reliable diagnostic method. Possible alternative methods of managing these cases are discussed.

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Origin of Peripheral Tuberculous Lymphadenitis in Childhood

Cited by 22 publications

References 5 publications

Peripheral Tuberculous Lymphadenitis

Peripheral Tuberculous Lymphadenitis

Mucosa‐associated lymphoid tissues as sites for uptake, carriage and excretion of tubercle bacilli and other pathogenic mycobacteria

Tuberculous cervical lymphadenopathy

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