Slowly enlarging cervical lymphadenopathy.

Chief complaint A 41 y/o male came with slowly enlarging non-tender cervical lymphadenopathy. Description Duration for this swelling is 1 year or more but shows rapid growth in 3 months. He complaints of fever with chills for 4-5 days. No other complaint. He has history of pulmonary tuberculosis. Vitals Temperature of 98.7 degrees Pulse 109 beats per minute, BP 105/75 mm Hg, RR 25 breaths per minute, Oral cavity clear. No other lymphadenopathy or any other disease. Lungs were clear bilaterally on auscultation. Lab reports CBC shows 6650 cells/μL, hemoglobin of 14.0 g/dL, and platelet count of 240,000 cells/μL. Alkaline phosphatase was elevated to 291 units/L (normal range 20-120 units/L), and total protein was also elevated at 10.3 g/dL (6.0-8.0 g/dL). Diagnosis What is the swelling can you tell?

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Tubercular adenitis Past h/o pulmonary tuberculosis Presenting complains of gradually enlarging cervical glands with fever are indicative of lesion Adv one excisional biopsy for confirmation Pt will need ATT again

Thanx dr Aditya Waghmare
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Cervical adenopathy ,non tender ,chronic DD HODGKINS LYMPHOMA TB cervical adinitis . ? Secondaries, Needs ENT check up to rule out pharyngeal, laryngeal primary Excision biopsy will confirm diagnosis

Thank you ,Dr Rajendra Rai
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Idealy ESR Mt xray chest fnac HP before this give 5 days aug625 bd enzoflam tds then do test most likely Tb Primary infection in gland possible Dd lyumphoma or hyperplasiaor abscess

Examine for other palpable lymph nodes Palpate liver and spleen Excisional biopsy of cervical lymph node D/ D Hodgkin Lymphoma va TB

CERVICAL LYMPHADENOPATHY.. NEED'S TO FIND OUT.. EITHER.. TUBERCULOS.. OR.. INFECTIVE.. NEED'S.. HEMOGRAM.. FNAC.. HPE.. CXR..

Chronic Tuberculae Adenitis, BCZ PT. IS OLD PTB, DO ESR, SERUM ADA, FNAC, USG L/A , CXR P/A

Thanx@Dr. Kute Ankush Sir Ji
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Due to bimodal occurrence , Hodgkin is also common in this age group. Biopsy is must.

R/o lymphoma Then common tb Then infectious mononucleosis

Tubercular lymphodeniphathy

Most likely tubercular cervical lymphadenitis considering his past history of PULMONARY tuberculosis. But I would suggest a F.N.A.C done to confirm the diagnosis D/D - Hodgkins lymphoma Non - Hodgkins lymphoma Sarcoidosis . Metastatic lymph nodes Infectious mononucleosis

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