Tuberculous lymphadenitis: a forgotten and delayed diagnosis in low-incidence countries

Mathiasen, Victor Dahl; Lillebæk, Troels; Wejse, Christian

doi:10.1007/s15010-021-01632-7

Cited by 4 publications

(4 citation statements)

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“…In CEUS imaging, a classification of CTL by YANG, et al was applied ( Fig. 2 ) [ 8 ]. The enhancement patterns of all lymph node lesions in CEUS were shown in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

The diagnostic value of contrast-enhanced ultrasound for cervical tuberculous lymphadenitis

Zhao

Shao

et al. 2022

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OBJECTIVE: To investigate the value of contrast-enhanced ultrasound (CEUS) for the diagnosis of cervical tuberculous lymphadenitis (CTL). METHODS: The cohort study included 203 consecutive patients diagnosed with cervical lymph node. Before pathological or laboratory confirmation, all patients underwent CEUS examination, and the imaging findings were analyzed afterward. The diagnostic efficiency of the CEUS imaging findings of CTL was evaluated. RESULTS: Nighty-seven patients of the 203 (47.8%) were pathologically or laboratory confirmed with a CTL diagnosis while the remainder (52.2%) were diagnosed with non-tuberculous lymphadenitis. Regarding the imaging findings of CEUS, it was more common in CTL patients to find a pattern of heterogeneous enhancement inside the lymph nodes relative to non-tuberculous patients [81.44% (79/97) vs 15.09% (16/106), P < 0.01]. The sensitivity of the feature in diagnosis for CTL was 81.44% and the specificity was 84.91%, resepectively. Furthermore, a pattern of peripheral rim-like enhancement had been notable in CTL patients compared with non-tuberculous patients [86.60% (84/97) vs 12.26% (13/106), P < 0.01], associating with a diagnostic sensitivity of 86.60% and a specificity of 87.74% . When it came to the combination of both imaging findings mentioned above, the features were more prominent in CTL patients than compared with non-tuberculous patients [74.23% (72/97) vs 5.66% (6/106), P < 0.01], with a diagnostic sensitivity of 74.23% and a high specificity of 94.34% . Regarding area under curve (AUC) for the ROC analysis, the feature of internal heterogeneous enhancement, peripheral rim-like enhancement, and both features were 0.832, 0.872, and 0.843. CONCLUSIONS: CEUS patterns of heterogeneous enhancement and peripheral rim-like enhancement of lymph nodes are helpful characteristics for the diagnosis of CTL.

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“…In CEUS imaging, a classification of CTL by YANG, et al was applied ( Fig. 2 ) [ 8 ]. The enhancement patterns of all lymph node lesions in CEUS were shown in Table 2 .…”

Section: Resultsmentioning

confidence: 99%

The diagnostic value of contrast-enhanced ultrasound for cervical tuberculous lymphadenitis

Zhao

Shao

et al. 2022

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“…These factors contribute to decreased diagnostic efficiency and delayed diagnosis. 6 There is a lack of published information regarding TL in the hepatic hilum. Therefore, this study aimed to contribute to a better understanding of porta hepatis TL and thus improve its diagnosis and treatment.…”

Section: Introductionmentioning

confidence: 99%

“…In addition, the site of infection may be challenging to access owing to the intricate structure of the hepatic hilar region, and the bacterial load is typically lower, making it difficult to obtain microbiological evidence of TB. These factors contribute to decreased diagnostic efficiency and delayed diagnosis 6 . There is a lack of published information regarding TL in the hepatic hilum.…”

Section: Introductionmentioning

confidence: 99%

Porta Hepatis Tuberculous Lymphadenopathy: Clinical and Imaging Features of 10 Cases

Hu,

Xia

et al. 2023

Infect Microb Dis

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Porta hepatis tuberculous lymphadenopathy (TL) is rare, and the clinical and imaging manifestations often mimic tumors. To offer a better understanding of porta hepatis TL and thus improve its diagnosis and treatment, here, we retrospectively reviewed and analyzed 10 porta hepatis TL cases between May 2017 and November 2022. In this study, porta hepatis TL occurred predominantly in women (70%), with a mean age of 43.1 years (range: 16–70 years). Among the patients, 60% were initially suspected of malignancy (metastatic lymphadenopathy and lymphoma). The clinical manifestations were non-specific, such as fever and weight loss, without overt abdominal malaise. Many patients showed high concentrations of serum C-reactive protein, erythrocyte sedimentation rate, alkaline phosphatase, γ-glutamyl transpeptidase, and carbohydrate antigen 125. Peripheral rim-like enhancement was a characteristic finding on contrast-enhanced CT for all the patients. Pathological examination confirmed the diagnosis in 90% of patients with caseous granulomatous inflammation and positive results of Xpert MTB/RIF, quantitative real-time PCR and/or metagenomic next-generation sequencing assays. All patients underwent anti-tuberculosis therapy with a median treatment duration of 13.5 months (range, 1–43 months). They all showed satisfactory therapeutic responses with improved symptoms and resolution on imaging after treatment. Pathological examination by biopsy remains the primary diagnostic method. A combination of the characteristic epidemiologic, clinical, imaging features and lesion biopsy for histopathology are essential for the diagnosis and treatment of TL.

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“…Likewise, adults should only be treated for latent tuberculosis at an increased lifetime risk of activation [ 2 ]. However, in the setting of unclear abdominal symptoms, active extrapulmonary tuberculosis should be considered as differential diagnosis, even if the IGRA is negative [ 3 ]. PET and mini-laparoscopy could contribute crucially to the rapid diagnosis of disseminated tuberculosis in this case [ 4 ].…”

mentioning

confidence: 99%

Disseminated tuberculosis during TNF-α inhibitor therapy diagnosed by positron emission tomography and mini-laparoscopy

2023

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Tuberculous lymphadenitis: a forgotten and delayed diagnosis in low-incidence countries

Cited by 4 publications

References 5 publications

The diagnostic value of contrast-enhanced ultrasound for cervical tuberculous lymphadenitis

The diagnostic value of contrast-enhanced ultrasound for cervical tuberculous lymphadenitis

Porta Hepatis Tuberculous Lymphadenopathy: Clinical and Imaging Features of 10 Cases

Disseminated tuberculosis during TNF-α inhibitor therapy diagnosed by positron emission tomography and mini-laparoscopy

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