Comparison of clinical and pathological features of lymph node tuberculosis and histiocytic necrotizing lymphadenitis

  • Jin-sun Yang Department of Infectious Diseases, Affiliated Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, China
  • Zhi-xiang Du Department of Infectious Diseases, Taizhou People's Hospital, Taizhou, Jiangsu 225300, China
Keywords: Lymph node tuberculosis, Histiocytic necrotizing lymphadenitis, Clinical features, Ultrasonographic features, Pathological features

Abstract

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.

Published
2019-08-31
How to Cite
1.
Yang J- sun, Du Z- xiang (2019) Comparison of clinical and pathological features of lymph node tuberculosis and histiocytic necrotizing lymphadenitis. J Infect Dev Ctries 13:706-713. doi: 10.3855/jidc.10860
Section
Original Articles