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What are the findings from the FNAC test and CT scan report?

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Hi, I have undergone few tests because of swollen enlarged lymphnodes in the right part of the neck between I don't have any symptoms of TB. Following are the tests: 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 continue with the prescription mentioned for TB or it may be another infection which caused this disease. Also, is it 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,
Posted Sat, 15 Feb 2014 in Infections
 
 
Answered by Dr. Hariom Sharma 1 hour later
Brief Answer: Continue with the prescription mentioned for TB Detailed Answer: Hi Sir, I have gone through your query and your tests, for this I personally suggests that you may continue with the prescription mentioned for TB for one month, if symptoms improved within this period then continue the treatment otherwise you may go for the 1. Excisional biopsy of the lymph node. 2. X ray Chest PA view. Because the classical histological pattern of tuberculosis cervical lymphadenitis is caseating granulomas with central acellular necrosis (caseous necrosis) surrounded by granulomatous inflammation with multinucleated giant cells. Although, tuberculous and non tuberculous lymphadenitis are morphologically identical. Also you have multiple enlarged lymphnodes, your country and age pointing towards TB lymphadenitis. Therefore best to go with your doctor. Wish you good health
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Follow-up: What are the findings from the FNAC test and CT scan report? 7 minutes later
Hi XXXXXXX The confusion I have here is " No caseous necrosis of foregin body evident" and it may not be an evident of TB. How far you are sure that it is " TB". Is it something could be related to "sarcoidosis" or any other disease Thanks,
 
 
Answered by Dr. Hariom Sharma 13 minutes later
Brief Answer: May be sarcoidosis but Detailed Answer: Hi Sir, I have gone through your follow up query and it may be sarcoidosis but it is a multiorgan granulomatous disease and there is no other sign and symptom. For the provisional diagnosis FNAC is good; but for definitive diagnosis you may go for excisional biopsy. You can talk to your treating doctor. Nevertheless, I don't find any serious harm in trying TB medicine for a month. Thanks
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Follow-up: What are the findings from the FNAC test and CT scan report? 38 minutes later
Thanks. Do we have medicine for sarcoidosis ?. If not, how this will be treated. is it will be cured automatically or how?
 
 
Answered by Dr. Hariom Sharma 15 minutes later
Brief Answer: Yes, We have medicine for sarcoidosis Detailed Answer: Hi Sir, Medicine are also available for your sarcoidosis; but the management depend on the severity of disease and involved organ as it is a multiorgan granulamatous disease. Wish you good health
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