Section of Infectious Diseases, University of Antioquia Medical School, Medellín, Colombia.
Section of Mycobacteria Research, Corporación para Investigaciones Biológicas and Universidad Pontificia Bolivariana, Medellín, Colombia.
Microbiol Spectr. 2016 Dec;4(6). doi: 10.1128/microbiolspec.TNMI7-0008-2016.
Tuberculous lymphadenitis is the most common extrapulmonary manifestation of disseminated tuberculosis (TB). It is considered to be the local manifestation of the systemic disease that has disseminated to local lymph nodes, but a high index of suspicion is needed for the diagnosis, because there are several infectious and noninfectious diseases that can mimic the same clinical picture. In recent years, different diagnostic methods have been introduced, including fine-needle aspiration cytology, which has emerged as a simple outpatient diagnostic procedure that replaced the complete excisional node biopsy, and a number of molecular methods which have greatly improved diagnostic accuracy. This chapter covers the most actual knowledge in terms of epidemiology, clinical manifestations, pathogenesis, and treatment and emphasizes current trends in diagnosis of tuberculous lymphadenitis. TB parotid gland involvement is extremely rare, even in countries in which TB is endemic. Because of the clinical similarity, parotid malignancy and other forms of parotid inflammatory disease always take priority over the rarely encountered TB parotitis when it comes to differential diagnosis. As a result, clinicians often fail to make a timely diagnosis of TB parotitis when facing a patient with a slowly growing parotid lump. This chapter highlights the most important features of this uncommon disease.
结核性淋巴结炎是播散性结核病（TB）最常见的肺外表现。它被认为是全身性疾病向局部淋巴结播散的局部表现，但需要高度怀疑才能做出诊断，因为有几种感染性和非感染性疾病可以模拟相同的临床特征。近年来，已经引入了不同的诊断方法，包括细针抽吸细胞学检查，它已成为一种简单的门诊诊断程序，取代了完整的切除性淋巴结活检，以及许多分子方法，这些方法极大地提高了诊断的准确性。本章涵盖了结核性淋巴结炎在流行病学、临床表现、发病机制和治疗方面的最新知识，并强调了目前结核性淋巴结炎诊断的趋势。结核性腮腺受累极为罕见，即使在结核病流行的国家也是如此。由于临床表现相似，当涉及到鉴别诊断时，腮腺恶性肿瘤和其他形式的腮腺炎症性疾病总是优先于罕见的结核性腮腺炎。因此，当面对一个腮腺肿块生长缓慢的患者时，临床医生往往无法及时诊断结核性腮腺炎。本章重点介绍了这种罕见疾病的最重要特征。
