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What Causes Multiple Lymph Nodes In Neck Region?
Question: have been diagnosed with multiple lymphnodes in the neck right hand side. Largest one of size 28x22mm showing liquefaction. Few nodes showing caseation necrosis as well as echogenic debris in it. Findings as per sonography are suggestive of cervical lymphadenopathy on the left side (Tubercular aetiology to be ruled out) with a partially adenomatous/goitrous nodule in the right lobe of thyroid.
What are the causes, implications and treatment.
What are the causes, implications and treatment.
Brief Answer:
Most likely tuberculous cervical lymphadenopathy & benign thyroid nodule
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
AS per sonography report it suggests tuberculous cervical lymphadenopathy (right side) as lymph nodes are multiple and shows caseation necrosis with echogenic debris. However one needs to get a tissue diagnosis. For that you have to undergo Fine needle aspiration cytology (FNAC) of the cervical lymph nodes and Aspiration material for culture of Mycobacterium tuberculosis to know the sensitivity pattern as ,these days there is often first-line drug resistance.
Since there is also a goitrous nodule which is reported partially adenoamatous ,you need to undergo thyroid function tests like serum T3,T4 & TSH to know your thyroid status.
It does not appear to be a malignant nodule with local cervical metastasis.
If tuberculosis is confirmed By FNAC or if FNAC is inconclusive, by cervical lymph node biopsy,tissue diagnosis of goitrous nodule by similar FNAC will not be needed.
Is there any past or family history of tuberculosis ?. An X-ray chest is imperative in your case.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Most likely tuberculous cervical lymphadenopathy & benign thyroid nodule
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
AS per sonography report it suggests tuberculous cervical lymphadenopathy (right side) as lymph nodes are multiple and shows caseation necrosis with echogenic debris. However one needs to get a tissue diagnosis. For that you have to undergo Fine needle aspiration cytology (FNAC) of the cervical lymph nodes and Aspiration material for culture of Mycobacterium tuberculosis to know the sensitivity pattern as ,these days there is often first-line drug resistance.
Since there is also a goitrous nodule which is reported partially adenoamatous ,you need to undergo thyroid function tests like serum T3,T4 & TSH to know your thyroid status.
It does not appear to be a malignant nodule with local cervical metastasis.
If tuberculosis is confirmed By FNAC or if FNAC is inconclusive, by cervical lymph node biopsy,tissue diagnosis of goitrous nodule by similar FNAC will not be needed.
Is there any past or family history of tuberculosis ?. An X-ray chest is imperative in your case.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
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Above answer was peer-reviewed by :
Dr. Shanthi.E
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