Should Biopsy Be Done To Check For Cervical Lymphadenopathy When Suffering From TB?
Question: Hi,
I have undergone few tests because of swollen of enlarged lymphnodes in the right part of the next between I don't have any symptoms of TB. Following are the ones :
1. CT- Scanning
2. X-Ray
3. FNAC
4. Blood Test
Seems to be everything normal except FNAC and CT-Scanning results. Initially, I undergone with CT-Scanning and it has been showed that " I have multiple enlarged lymphnodes seen in the upper side, lower and mid cervical region of varying sizes, measuring -2.4*1.1. cm premominately posterior to sternocleido mastoid. So, they have asked to go for FNAC. With the FNAC results, it was shown that I'm having Tuberculosis and the following are the results :
Smears show moderate cellularity with presence of numberous aggregates of epitheloid cells and few multinucleate cells in a background of small lymphocytes,immunoblasts,histiocytes and few capilaries.
No atypical cells seen. No caseous necrosis of foregin body evident.
Impression: Non-caseating granulomatous lymphadentis.
Finally, they are asked me to undergo for TB treatment and prescribed antibiotics.
So, Should i need to biopsy for confirmatory or should i continue with the prescription mentioned for TB or it may be another infection which caused this disease. Also, its a latent or inactive TB and i don't see much increase in size since 2 months.
Kindly, let me have your your valuable feedback on this.
Thanks in advance,
Brief Answer:
Follows.
Detailed Answer:
Dear Sir,
Thank you for posting your query on XXXXXXX
Well looking into your problem I would like to tell you that you should go for biopsy .
You ahve mentioned non casetion necrosis in FNAC finding , it is not suggestive of TB . Caseation necrosis is hallmark for TB infection .So, it is not favouring TB .
Ct report is just showing lymph nodes it is not suggestive of any diagnosis.
Although tuberculosis is the most common cause for cervical lymphadenopathy in india and a trial of anti tubercular drugs is often given even in absence of proof for TB , Still if you have the facility go for biopsy . Sarcoidosis also needs to be ruled out .
Take care.
Dr. Shruti
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Hi XXXXXXX
If not TB, what could be the reason ?. Is it some thing related to Cancer, if yes I dont see any atypical cells in the report ?. Can you please advice before going for Sarcoidosis
Thanks,
Brief Answer:
Follows.
Detailed Answer:
Dear Sir ,
Cause cannot be commented upon . BIOPSY IS THE GOLD STANDARD , it needs to be done only after that anything can be said with confirmation .
Get your Serum ACE level , calcium levels done for sarcoidosis .
Mantoux test and ESR levels also need to be seen .
Dr. Shruti
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar