Clinico-diagnostic experience with tuberculous lymphadenitis in Saudi Arabia

Objective To describe the diagnosis and outcomes of tuberculous lymphadenit is in a low HIV-seroprevalence population at a hospital in Riyadh, Saudi Ar abia. Methods Retrospective case series of tuberculous lymphadenitis from 1983 to 1998 were examined. Results There were 99 cases with a median age of 38 years and a female prep onderance (female/male ratio of 1.3 : 1). Eighty per cent had cervical invo lvement and 36% had systemic symptoms. Eighty-nine per cent had their lymph adenopathy for more than 1 month. The diagnostic yield of tuberculin skin t esting was 83%, of chest X-ray was 27%, of fine-needle aspiration was 46%, and of excisional lymph node biopsy was 97%. Only one-third of patients rec eived a tuberculin test. There was no significant difference in outcome bet ween 6 and 9 months of chemotherapy, and paradoxical enlargement of nodes o ccurred in only 6%. Conclusions Tuberculous lymphadenitis in our study population was predomina ntly cervical in location. The diagnostic yield of FNA was lower than that reported in the literature, and might be improved by more frequent tubercul in skin testing, multiple aspirations of lymph nodes, or use of excisional biopsy as the initial diagnostic procedure. Most patients responded well to chemotherapy, with few complications.