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inflammation of lymph nodes

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結核（性）の・ゲッカコウ(月下香)(ヒガンバナ科の球根植物)

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出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/12/23 14:47:43」(JST)

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Tuberculous lymphadenitis (or tuberculous adenitis) is a chronic specific granulomatous inflammation of the lymph node with caseation necrosis, caused by infection with Mycobacterium tuberculosis or Mycobacterium bovis.

The characteristic morphological element is the tuberculous granuloma (caseating tubercule). This consists of giant multinucleated cells and (Langhans cells), surrounded by epithelioid cells aggregates, T cell lymphocytes and fibroblasts. Granulomatous tubercules eventually develop central caseous necrosis and tend to become confluent, replacing the lymphoid tissue.

Stages of Tubercular Lymphadenitis -

Lymphadenitis
Periadenitis
Cold abscess
'Collar stud' abscess
Sinus

Tuberculous lymphadenitis is popularly known as Collar stud abscess, due to its proximity to the collar bone and superficial resemblance to a collar stud, although this is just one of the five stages of the disease. The characteristic morphological element is the tuberculous granuloma (caseating tubercule): giant multinucleated cells (Langhans cells), surrounded by epithelioid cells aggregates, T cell lymphocytes and few fibroblasts. Granulomatous tubercules evolve to central caseous necrosis and tend to become confluent, replacing the lymphoid tissue.

Treatment

Incision drainage with proper evacuation of the abscess, followed by anti-tubercular antibiotic treatment.

External links

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1. 結核性リンパ節炎 tuberculous lymphadenitis
2. 成人における末梢リンパ節腫大の評価 evaluation of peripheral lymphadenopathy in adults
3. 小児における非結核性抗酸菌性リンパ節炎の概要 overview of nontuberculous mycobacterial lymphadenitis in children
4. 小児における末梢のリンパ節腫脹の原因 causes of peripheral lymphadenopathy in children
5. 肺外結核および粟粒結核の臨床症状、診断、および治療 clinical manifestations diagnosis and treatment of extrapulmonary and miliary tuberculosis

English Journal

Disseminated tuberculosis in an HIV-infected child: rifampicin resistance detected by GeneXpert in a lymph node aspirate but not in cerebrospinal fluid.

Gamell A1, Ntamatungiro AJ2, Battegay M3, Letang E1.
BMJ case reports.BMJ Case Rep.2015 Aug 3;2015. pii: bcr2014207997. doi: 10.1136/bcr-2014-207997.
A 9-year-old HIV-infected child previously treated with inadequate doses of antitubercular drugs based on weight was admitted 5 months after initial tuberculosis (TB) diagnosis with acute hemiplegia and inguinal lymphadenopathies in a rural hospital in Tanzania. He was diagnosed with TB meningitis
PMID 26240094

Host susceptibility to non-tuberculous mycobacterial infections.

Wu UI1, Holland SM2.
The Lancet. Infectious diseases.Lancet Infect Dis.2015 Aug;15(8):968-80. doi: 10.1016/S1473-3099(15)00089-4. Epub 2015 Jun 3.
Non-tuberculous mycobacteria cause a broad range of clinical disorders, from cutaneous infections, such as cervical or intrathoracic lymphadenitis in children, to disseminated infections at all ages. Recognition of the underlying immune defect is crucial for rational treatment, preventive care, fami
PMID 26049967

Tuberculous periportal lymphadenitis: A diagnostic challenge.

Ramia JM1, Diaz-Morfa M2, Caminoa A3, Gijón L4, de la Plaza R5.
Cirugia espanola.Cir Esp.2015 Jul 31. pii: S0009-739X(15)00171-2. doi: 10.1016/j.ciresp.2015.05.009. [Epub ahead of print]
PMID 26238428