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Diagnosed with granulomatous lymphadenitis. FNAC of the neck lymph nodes done. Advised to go for TB treatment. Is this test sufficient for the diagnosis?

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My cousin, Male, 30 yrs old has been diagnosed with granulomatous lymphadenitis. Tests done were FNAC of the lymphnodes in the neck region. He has been advised to undergo treatment for Tubeculosis. Is this test sufficient to diagnose the cause of lymphadenitis as TB or is there any other specific test he needs to undergo? Kindly advise.
Posted Sun, 1 Jul 2012 in Lung and Chest disorders
Answered by Dr. Chandana Krishna 3 hours later

Thank you for writing in.

Any granulomatous lymphadenitis in Indian set up is suspected of Tubercular origin.

Other causes are Sarcoidosis, bacterial or viral adenitis or due to malignancies.
Yes F.N.A.C is sufficient evidence to start treatment for Tuberculosis. It gives a typical pattern which is specific for T.B.(epitheloid granuloma, langhans giant cells).
Some specialist also depends on other associated features like
- was there any contact with case of T.B.
-was there associated symptoms of fever, night sweats, weight loss, fatigue.
-is the lymph node painful or painless and is there any matting(attaching) of 2-3 lymph nodes

Excision biopsy is the gold standard confirmatory test. Kindly talk to your physician about excision biopsy is required or not.

For your information, now TB has become a notifiable disease in India, it means it has to be reported at the local District TB centre. Did your doctor do it? Please ask about this too.

If you have any doubt feel free to ask, I'll be happy to help you.

Wishing you and your brother good health.
Above answer was peer-reviewed by
Follow-up: Diagnosed with granulomatous lymphadenitis. FNAC of the neck lymph nodes done. Advised to go for TB treatment. Is this test sufficient for the diagnosis? 2 days later
Thank you for your quick response Dr. XXXXXXX I have one query in this connection - I understand the standard drugs prescribed are AKT4 or AKURIT4. Is there any chance of both these drugs (or a combination of these) being prescribed for treatment? My cousin is slightly underweight.

Thank you in advance

Answered by Dr. Chandana Krishna 1 hour later
Thank you for writing in,
AKT4 and AKURIT4 have same composition i.e., Isoniazid, rifampicin, ethanbutol and pyrazinamide.
But AKURIT4 has single capsule with components in low doses and AKT4 has 4 capsules.
Either of one is given usually.
Which one to give is decided by the physician after analyzing the physical condition of the patient like age, weight, severity of the disease.
Kindly talk to his physician about this.
Above answer was peer-reviewed by
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