結核性頸部リンパ節炎の2例

抄録

Two cases of cervical tuberculous lymphadenitis are presented. The first was a 63-year-old woman, complaining of tumors in the lateral neck region. Both tumors were clearly separated and elastic hard. One tumor was movable in the submandibular region, but another tumor in the neck region was not well in mobility. Clinically, neoplasm was suspected and extirpation of the tumors were carried out. Histopathological examination of the enucleated materials revealed central caseous necrosis with Langhans' giant cells and proliferation of epitheloid cells. The two tumors were diagnosed as tuberculous lymphadenitis after considering positive reaction of tuberculin skin test, acceleration of ESR and histopathological findings. The second case was a 64-year-old man, complaining of tumor in the submental region. At first examination the tumor was found to be thumb finger size, clearly separated and elastic hard. This tumor increased in walnut size with reduction mobility of in a week. Malignant neoplasm was suspected and extirpation of the tumor was carried out. Histopathological examination of the enucleated material revealed central caseous necrosis with proliferation of epitheloid cells. The tumor was diagnosed as tuberclous lymphadenitis after considering positive reaction of tuberculin skin test, acceleration of ESR and histopathological findings. In both cases, tubercle bacilli were not observed and the chest X-ray films showed no pulmonary tuberculosis. Because clinical symptoms of cervical tuberculous lymphadenitis resemble that of malignant neoplasm, care should be taken at diagnosis.