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Should biopsy be done to check for cervical lymphadenopathy when suffering from TB?

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Practicing since : 2008
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Hi, I have undergone few tests because of swollen of enlarged lymphnodes in the right part of the next between I don't have any symptoms of TB. Following are the ones : 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 need to biopsy for confirmatory or should i continue with the prescription mentioned for TB or it may be another infection which caused this disease. Also, its 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 Tue, 4 Feb 2014 in Infections
Answered by Dr. Shruti Rijhwani 27 minutes later
Brief Answer: Follows. Detailed Answer: Dear Sir, Thank you for posting your query on XXXXXXX Well looking into your problem I would like to tell you that you should go for biopsy . You ahve mentioned non casetion necrosis in FNAC finding , it is not suggestive of TB . Caseation necrosis is hallmark for TB infection .So, it is not favouring TB . Ct report is just showing lymph nodes it is not suggestive of any diagnosis. Although tuberculosis is the most common cause for cervical lymphadenopathy in india and a trial of anti tubercular drugs is often given even in absence of proof for TB , Still if you have the facility go for biopsy . Sarcoidosis also needs to be ruled out . Take care. Dr. Shruti
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Follow-up: Should biopsy be done to check for cervical lymphadenopathy when suffering from TB? 10 minutes later
Hi XXXXXXX If not TB, what could be the reason ?. Is it some thing related to Cancer, if yes I dont see any atypical cells in the report ?. Can you please advice before going for Sarcoidosis Thanks,
Answered by Dr. Shruti Rijhwani 7 minutes later
Brief Answer: Follows. Detailed Answer: Dear Sir , Cause cannot be commented upon . BIOPSY IS THE GOLD STANDARD , it needs to be done only after that anything can be said with confirmation . Get your Serum ACE level , calcium levels done for sarcoidosis . Mantoux test and ESR levels also need to be seen . Dr. Shruti
Above answer was peer-reviewed by
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