Comparison of clinical and pathological features of lymph node tuberculosis and histiocytic necrotizing lymphadenitis
Introduction: The aim of this study was to investigate the basis for a differential diagnosis of lymph node tuberculosis and histiocytic necrotizing lymphadenitis.
Methodology: This study selected 85 cases of lymph node tuberculosis (Group A patients) and 26 cases of histiocytic necrotizing lymphadenitis (Group B patients). The clinical and pathology features on both groups were analysed.
Results: The Group A patients were older than the Group B patients (t = 5.233, P < 0.01); The Group B patients had less tuberculosis exposure history (x2 = 4.279, P < 0.01), and a higher frequency of tenderness (χ2 = 8.109, P < 0.01) and fever (x2 = 31.923, P < 0.01). The Group A patient group had a higher WBC level (t = 2.980, P < 0.01) and lower serum ALB (t = 5.508, P < 0.01); As seen through ultrasound imaging, Group B patients had more clear boundaries (70.59%), higher low-echo rates (82.36%) and low calcification rates (0%), Group A patients for whom these rates was 25.76%, 40.91% and 25.76% respectively. In terms of pathology data, the main manifestations of Group A patients were granulomatous inflammation with caseous necrosis, multinuclear giant cell reaction, and in some cases, acid-fast bacilli smears (+). In Group B patients, there were instances of coagulative necrosis surrounded by foam-like tissue cells without neutrophil infiltration.
Conclusion: We found that the epidemiological history, clinical symptoms, laboratory examinations, ultrasound imaging and changes in pathology are very important for the identification of lymph node tuberculosis and histiocytic necrotizing lymphadenitis.
Copyright (c) 2019 Jin-sun Yang, Zhi-xiang Du
This work is licensed under a Creative Commons Attribution 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).