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What Do These FNAC, Biopsy And ESR Test Results Indicate?
Question: Summing up the events in chronological order as they transpired:
//Early Sept'14 : Wife discovered small lump towards right side of the neck.
//Oct Mid'14 : Lump got swelled gradually in a month time and caught our attention.
//Oct last'14 : As we were in our hometown (haryana), we visited local Surgeon and asked to undergo Blood, Urine, ESR, Regular needle FNAC Test. Except High ESR, rest of the results were negative.
//Oct last'14 : Visited another renowned TB specialist and undergone, Chest Xray, TB skin test, again needle FNAC. Except Skin test which was partial positive, everything else was negative. Referred for Biopsy.
//Oct last'14: We reacted swiftly, and through a known surgeon (cousin brother), Biopsy got done. Waited for a week for the results. Outcome was inconclusive/Negative with no malignancy found & reactive lymphnoid hyperplasia. Surgeon/cousin bro. further referred for Ultrasound guided FNAC and results were positive, so concluded TB.
Apart from that, stomach ultrasound, USG whole abdomen, LDH was also carried out and result was negative.
// Early Nov'14: We reached back to our work place XXXXXXX and thought of taking opinion here as its a long treatment and need continuous doc involvement. Here underwent Chest and neck CT scan and outcome was negative. Based on the previous Tests, we were advised to start TB treatment and now its been two months.
After going through all these tests, and continuing (AKT4) medicine for two months, their is no improvement. Infact the size has grown by another 10%.
Yesterday we got LFT done and doc. advised to stop the medication for now as few stats (OT & PT) were 7-8 times higher.
All the reports are enclosed.
No other symptoms like fever, weight loss, sweating, weekness, decreased appetite is there.
Best Regards
//Early Sept'14 : Wife discovered small lump towards right side of the neck.
//Oct Mid'14 : Lump got swelled gradually in a month time and caught our attention.
//Oct last'14 : As we were in our hometown (haryana), we visited local Surgeon and asked to undergo Blood, Urine, ESR, Regular needle FNAC Test. Except High ESR, rest of the results were negative.
//Oct last'14 : Visited another renowned TB specialist and undergone, Chest Xray, TB skin test, again needle FNAC. Except Skin test which was partial positive, everything else was negative. Referred for Biopsy.
//Oct last'14: We reacted swiftly, and through a known surgeon (cousin brother), Biopsy got done. Waited for a week for the results. Outcome was inconclusive/Negative with no malignancy found & reactive lymphnoid hyperplasia. Surgeon/cousin bro. further referred for Ultrasound guided FNAC and results were positive, so concluded TB.
Apart from that, stomach ultrasound, USG whole abdomen, LDH was also carried out and result was negative.
// Early Nov'14: We reached back to our work place XXXXXXX and thought of taking opinion here as its a long treatment and need continuous doc involvement. Here underwent Chest and neck CT scan and outcome was negative. Based on the previous Tests, we were advised to start TB treatment and now its been two months.
After going through all these tests, and continuing (AKT4) medicine for two months, their is no improvement. Infact the size has grown by another 10%.
Yesterday we got LFT done and doc. advised to stop the medication for now as few stats (OT & PT) were 7-8 times higher.
All the reports are enclosed.
No other symptoms like fever, weight loss, sweating, weekness, decreased appetite is there.
Best Regards
Brief Answer:
You may have multi drug resistant TB or your treatment is not effective.
Detailed Answer:
Hi, Dear
I have gone through your all reports and your all questions. I can understand your concern.
Your FNAC, biopsy and ESR results are suggestive of tuberculous lymphadenitis.
You may have treatment failure due to either
1. Ineffective dosage. You should take all 4 drugs at same time. or
2. Multidrug resistant tuberculosis.
Moreover anti tuberculosis drugs like rifampicin and isoniazide are hepatotoxic. Your liver function test is altered due to anti tuberculous drugs.
You should go for culture and sensitivity test.
It will give you perfect idea about drug effectivity like which drugs will be effective and which is not effective against your tuberculous bacteria.
You should start treatment according to that report.
Your rest all reports of urine and blood are normal. No need to worry about that.
Consult your doctor and take treatment accordingly.
You may have multi drug resistant TB or your treatment is not effective.
Detailed Answer:
Hi, Dear
I have gone through your all reports and your all questions. I can understand your concern.
Your FNAC, biopsy and ESR results are suggestive of tuberculous lymphadenitis.
You may have treatment failure due to either
1. Ineffective dosage. You should take all 4 drugs at same time. or
2. Multidrug resistant tuberculosis.
Moreover anti tuberculosis drugs like rifampicin and isoniazide are hepatotoxic. Your liver function test is altered due to anti tuberculous drugs.
You should go for culture and sensitivity test.
It will give you perfect idea about drug effectivity like which drugs will be effective and which is not effective against your tuberculous bacteria.
You should start treatment according to that report.
Your rest all reports of urine and blood are normal. No need to worry about that.
Consult your doctor and take treatment accordingly.
Note: Do you have more questions on diagnosis or treatment of blood disorders? Ask An Expert/ Specialist Now
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Answered by
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