Khalil E A, Elsiddig K E, Elsafi M E, el-Hag I A, Elkhidir I M, Suleiman G, Hussein A M, Ibrahim M E, el-Hassan A M
Institute of Endemic Diseases, University of Khartoum, Sudan.
Trans R Soc Trop Med Hyg. 2000 Jan-Feb;94(1):58-60. doi: 10.1016/s0035-9203(00)90440-1.
Extra-pulmonary tuberculosis remains a diagnostic and therapeutic challenge; its clinical presentation can mimic a wide range of pathological conditions. Here we report on 3 female patients who presented with supra-sternal masses that were suspected clinically to be of thyroid origin. By use of fine-needle aspiration cytology (FNAC), they were proved to be tuberculous lesions involving the pre-tracheal lymph nodes. Serological examination for HIV-I/II was not reactive in the 3 patients. The patients responded well to a regimen of multi-drug therapy. It is concluded that extra-pulmonary tuberculosis should be considered in the differential diagnosis of thyroid or para-thyroid swellings and that FNAC is a simple, quick and reliable procedure in the diagnosis of extra-pulmonary tuberculous lesions involving the neck.
肺外结核仍然是一个诊断和治疗上的挑战;其临床表现可模仿多种病理状况。在此,我们报告3例女性患者,她们表现为胸骨上肿块,临床怀疑为甲状腺来源。通过细针穿刺细胞学检查(FNAC),证实这些肿块是累及气管前淋巴结的结核病变。这3例患者的HIV-I/II血清学检查均无反应。患者对多药治疗方案反应良好。结论是,在甲状腺或甲状旁腺肿大的鉴别诊断中应考虑肺外结核,并且FNAC是诊断累及颈部的肺外结核病变的一种简单、快速且可靠的方法。