Histopathological Review of Granuloma in Diagnosis of Tuberculosis Lymphadenitis (TBL)

Wida Purbaningsih, Meike Rachmawati, Yani Triyani, Fadhilat Sabila Rahmi

Abstract


Tuberculosis (TB) is an infectious disease caused by Mycobacterium tuberculosis and is the second leading cause of death from an infectious disease. Indonesia has the highest TB cases in West Java, East Java, and Central Java. Tuberculosis lymphadenitis (TBL) represents about 30–40% of cases of extrapulmonary tuberculosis. The study aimed to study the clinical and histopathological characteristics of TBL patients. The research design in this study used an exploratory, descriptive method. Data was taken from Al Islam Hospital Bandung as medical records from January 2019 to December 2020. The result showed that TBL primarily affects patients aged 6–11 years (28%), male gender (57%), patients not working (25%), and those residing in the East Bandung area (34%). Histopathological appearance showed granulomas of caseous necrosis, epithelioid cells, and Langhan's cells, indicated by types 1, 2, and 3. The most common type was type 1 (47%), which was more widely distributed in the right neck (46%) with size 1–3 cm. In conclusion, the frequency of TBL is higher in boys aged 6–11 years, residents of the East Bandung area, and patients who did not work. Well-formed granuloma of enlarged lymph nodes in the right neck with size 1–3 cm is most commonly found in TBL.


Keywords


Histopathological review; lymphadenitis; tuberculosis

Full Text:

PDF

References


World Health Organization. Global tuberculosis report 2022. Geneva: World Health Organization; 2022.

Erida Y. Limfadenitis tuberculosis [Internet]. Jakarta: Direktorat Jenderal Pelayanan Kesehatan Kementerian Kesehatan Republik Indonesia; 2022 [cited 2023 August 23]. Available from: https://yankes.kemkes.go.id/view_artikel/204/limfadenitis-tuberculosis.

Abebe G, Bonsa Z, Kebede W. Treatment outcomes and associated factors in tuberculosis patients at Jimma University Medical Center: a 5‑year retrospective study agenda. Int J Mycobacteriol. 2019;8(1):35–41.

Sharma SK, Mohan A, Kohli M. Extrapulmonary tuberculosis. Expert Rev Respir Med. 2021;15(7):931–48.

Lemus LF, Revelo E. Cervical tuberculous lymphadenitis. Cureus. 2022;14(11):e31282.

Ahmed HGE, Nassar AS, Ginawi I. Screening for tuberculosis and its histological pattern in patients with an enlarged lymph node. Patholog Res Int. 2011:2011:417635.

Huda MM, Taufiq M, Yusuf MA, Rahman MR, Begum F, Kamal M. Histopathological features of lymph nodes of tuberculous lymphadenitis patients: experience of 50 cases in Bangladesh. Bangladesh J Infect Dis. 2016;3(2):40–2.

Ketata W, Rekik WK, Ayadi H, Kammoun S. Extrapulmonary tuberculosis. Rev Pneumol Clin. 2015;71(2–3):83–92.

Yang JS, Du ZX. Comparison of clinical and pathological features of lymph node tuberculosis and histiocytic necrotizing lymphadenitis. J Infect Dev Ctries. 2019;13(8):706–13.

Ali S, Mubeen A, Javed M. Demographic features of tuberculosis lymphadenitis patients. J Sheikh Zayed Med Coll. 2014;5(4):730–2.

Bottineau MC, Kouevi KA, Chauvet E, Garcia DM, Galetto-Lacour A, Wagner N. A misleading appearance of a common disease: tuberculosis with generalized lymphadenopathy-a case report. Oxf Med Case Reports. 2019;2019(9):omz090.

Tahseen S, Ambreen A, Ishtiaq S, Khanzada FM, Safdar N, Sviland L, et al. The value of histological examination in diagnosing tuberculous lymphadenitis in the era of rapid molecular diagnosis. Sci Rep. 2022;12(1):8949.

Rana S, Bhat P, Bhat S, Bakshi V, Bisht RS. Clinico-pathological and demographic profile of patients of cervical tubercular lymphadenitis in the hilly region of Uttarakhand. Int J Health Sci (Qassim). 2022;6(Suppl 3):4232–9.

Kamal MS, Hoque MH, Chowdhury FR, Farzana R. Cervical tuberculous lymphadenitis: clinico-demographic profiles of patients in a secondary level hospital of Bangladesh. Pak J Med Sci. 2016;32(3):608–12.

Gautam H, Agrawal SK, Verma SK, Singh UB. Cervical tuberculous lymphadenitis: clinical profile and diagnostic modalities. Int J Mycobacteriol. 2018;7(3):212–6.

Jha BC, Dass A, Nagarkar NM, Gupta R, Singhal S. Cervical tuberculous lymphadenopathy: changing clinical pattern and concepts in management. Postgrad Med J. 2001;77(905):185–7.

Gulati HK, Mawlong M, Agarwal A, Ranee KR. Comparative evaluation of clinical, cytological and microbiological profile in abdominal vs. cervical lymph nodal tuberculosis with special emphasis on utility of auramine-O staining. J Cytol. 2021;38(4):191–7.

Pagán AJ, Ramakrishnan L. Immunity and immunopathology of tuberculosis granuloma. Cold Spring Harb Perpect Med. 2015;5(9):a018499.

Lake AM, Oski FA. Peripheral lymphadenopathy in childhood. Ten-year experience with excisional biopsy. Am J Dis Child. 1978;132(4):357–9.

Fatmi TI, Jamal Q. A morphological study of chronic granulomatous lymphadenitis with the help of special stains. Pak J Med Sci. 2002;18(1):48–51.

Dasgupta S, Chakrabarti S, Sarkar S. Shifting trend of tubercular lymphadenitis over a decade – a study from eastern region of India. Biomed J. 2017;40(5):284–9.

Hemalatha A, Shruti P, Kumar MU, Bhaskaran A. Cytomorphological patterns of tubercular lymphadenitis revisited. Ann Med Health Sci Res. 2014;4(3):393–6.




DOI: https://doi.org/10.29313/gmhc.v11i3.12742

pISSN 2301-9123 | eISSN 2460-5441


Visitor since 19 October 2016: 


Free counters!


Global Medical and Health Communication is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.