Niaz Hussain Soomro, Aneeqa Ahsan Zafar, Jamal Nasir, Aamna Binte Zahid, Mariam Fazal, Ubedullah Shaikh


Background: TB can affect virtually any organ of the body and can be pulmonary or extrapulmonary. Extrapulmonary tuberculosis accounts for 20% of all TB cases with lymph nodes being the most common site of occurrence. The objective of this study was to determine the frequency of extrapulmonary tuberculosis in patients presenting with cervical lymphadenopathy.
Material & Methods: This was a descriptive study conducted at Department of Thoracic Surgery, Ojha Institute of Chest Diseases, Dow University of Health Sciences, Karachi, Pakistan from December 2012 to April 2015. All patients who presented with cervical lymphadenopathy which was not secondary to acute ear, nose, throat or dental infection or enlarged thyroid swellings/mass were included in the study. After informed consent, history, physical examination, ultrasonography of neck and FNAC were performed in all patients. Those patients in which FNAC failed to confirm the diagnosis, underwent lymph node biopsy
Results: A total of 491 patients, including 322(65.5%) females and 169(33.5%) males were studied. The mean age of patients was 33.8 years. All the patients complained of neck swelling followed by fever in 248(50.4%) and cough in 172(35.1%). Regarding the mode of diagnosis 310(63.2%) patients were diagnosed on FNAC, 112(22.8%) on excisional and 69(14%) on incisional biopsy. Among these 363(74.1%) patients were diagnosed with tuberculosis. Reactive hyperplasia was the next common diagnosis in 50(10.3%) patients.
Conclusion: Tuberculosis is the commonest cause of cervical lymphadenopathy in developing countries and should be investigated in every case of cervical lymphadenopathy with FNAC and/or biopsy.


Reactive hyperplasia; Lymphadenopathy; Extrapulmonary tuberculosis.

Full Text:



Ullah S, Shah AH, Aziz-ur-Rahman, Kamal A, Begum N, Khan G. Extrapulmonary tuberculosis in Lady Reading Hospital Peshawar, NWFP, Pakistan: survey of biopsy results. J Ayub Med Coll Abbottabad 2008; 20: 43-6.

Dye C, Scheele S, Dolin P, Pathania V, Raviglione MC. Global burden of tuberculosis-estimated incidence, prevalence, and mortality by country. J Am Med Assoc 1999; 282: 677-86.

Memish ZA, Bamgboye EA, Abuljadayel N, Smadi H, Abouzeid MS, Hakeem RFA. Incidence of and risk factors associated with pulmonary and extra-pulmonary tuberculosis in Saudi Arabia (2010-2011). PLoS ONE 2014; 9: e95654.

Marais BJ, Wright CA, Schaaf HS, Gie RP, Hesseling AC, Enarson DA. Tuberculous lymphadenitis as a cause of persistent cervical lymphadenopathy in children from a tuberculosis-endemic area. Pediatr Infect Dis J 2006; 25: 142-6.

Jha BC, Dass A, Nagarkar NM, Gupta R, Singhal S. Cervical tuberculous lymphadenopathy: changing clinical pattern and concepts in management. Postgrad Med J 2001; 77: 185-7.

Mert A, Tabak F, Ozaras R, Tahan V, Ozturk R, Aktuglu Y. Tuberculous lymphadenopathy in adults: a review of 35 cases. Acta Chir Belg 2002; 102: 118-21.

Noertjojo K, Tam CM, Chan SL, Chan-Yeung MM. Extrapulmonary and pulmonary tuberculosis in Hong Kong. Int J Tuberc Lung Dis 2002; 6: 879-86.

Rajasekaran S, Gunasekaran M, Jayakumar DD, Jeyaganesh D, Bhanumathi V. Tuberculous cervical lymphadenitis in HIV positive and negative patients. Ind J Tuber 2001; 48: 201-4.

Karstaedt AS. Extrapulmonary tuberculosis among adults: experience at Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa. S Afr Med Jr 2013; 104: 22-4.

Artenstein AW, Kim JH, Williams WJ, Chung RC. Isolated peripheral tuberculous lymphadenitis in adults: current clinical and diagnostic issues. Clin Infect Dis 1995; 20: 876-82.

Fazal-i-Wahid, Habib-ur-Rahman, Ahmed I. Extrapulmonary tuberculosis in patients with cervical lymphadenopathy. J Pak Med Assoc 2013; 63: 1094-7.

Karim MM, Choudhury SA, Husain MM, Faiz MA. A clinical study on extrapulmonary tuberculosis. J Bangladesh Coll Phys Surg 2006; 24: 19-28.

Grange JM. The rapid diagnosis of paucibacillary tuberculosis. Tubercle 1989; 70: 1-4.

Reddy MP, Moorchung N, and Chaudhary A. Clinicopathological profile of pediatric lymphadenopathy. Indian J Pediatrics 2002; 69: 1047-51.

Panchal M, Chavan YH, Deshpande SA, Suvermakar SV, Meshram DP. Role of fine needle aspiration cytology in pediatric age group. IOSR J Dent Med Sci 2014; 13: 59-63.

Fontanilla JM, Barnes A, Fordham C. Current diagnosis and management of peripheral tuberculous lymphadenitis, Clin Infect Dis 2011; 53: 555-62.


  • There are currently no refbacks.

Copyright (c) 2020 Niaz Hussain Soomro, Aneeqa Ahsan Zafar, Jamal Nasir, Aamna Binte Zahid, Mariam Fazal, Ubedullah Shaikh

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.