MRCP UK EXAMINATIONS

ABDOMINAL

GENERALISED LYMPHADENOPATHY

Question [CLICK ON ANY CHOICE TO KNOW THE RIGHT ANSWER]
A 24-year-old man presented with enlarged cervical lymphatic node. A histological investigation revealed the growth of epithelioid, lymphoid cells and macrophages with nuclei in the form of a horseshoe. In some centers the aggregates of unstructured light pink color masses with nuclei fragments were determined. For what disease the described changes are characteristic?
A
Tuberculosis
B
Lymphogranulomatosis (Hodgkin’s disease)
C
Actinomycosis
D
Metastasis of tumor
Explanation: 

Detailed explanation-1: -The lymph node TB usually causes a painful swelling of one or more lymph nodes. Most often, the disease is localized to the anterior or posterior cervical chains (70-90%) or supra clavicular. It is often bilateral and non-contiguous lymph nodes can be involved [3].

Detailed explanation-2: -Tubercular cervical lymphadenitis is an inflammatory reaction. Lymph nodes may be affected by four methods of tubercular infection: Primary Any site where TB bacilli gains entry into a non allergic tissue like tonsils, adenoids, teeth, ear or skin of jaw. Commonest being the tonsil (1–4%).

Detailed explanation-3: -The most major histological features were giant cell (88%), caseation (84%), epithelioid cells (80%), granuloma and caseation (68%), lymphocytes (31%), and histiocytes (4%).

Detailed explanation-4: -Cervical tuberculosis is usually a result of an infection in the lymph nodes, known as lymphadenitis. Extrapulmonary tuberculosis, such as scrofula, is observed most often in individuals who are immunocompromised.

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