Assessment of lymph node tuberculosis in northern Germany: a clinical review

Chest. 2002 Apr;121(4):1177-82. doi: 10.1378/chest.121.4.1177.


Aim of study: To evaluate patient profiles, diagnostic approaches, and treatment strategies in patients with lymph node tuberculosis.

Methods: Demographic data, diagnostic findings, and therapies were retrospectively analyzed in 60 patients with lymph node tuberculosis who were hospitalized between 1992 and 1999.

Results: Thirty percent (n = 18) of patients were natives, and 70% were immigrants (n = 42). The cervical lymph nodes were most frequently involved (63.3%), followed by the mediastinal lymph nodes (26.7%) and the axillary lymph nodes (8.3%). All patients (except one patient who was HIV-positive) showed a positive response to tuberculin skin testing. Lymph node excision and fine-needle aspiration (FNA) were similarly effective in obtaining sufficient material for histologic and microbiological analysis. Mycobacterium tuberculosis was identified in 43.3% of patients by microbiological testing, and culture methods showed the highest sensitivity. Despite standard treatment, the initial enlargement of the lymph nodes occurred in 20% of patients and local complications occurred in 10%.

Conclusion: Lymph node tuberculosis is still an important issue in developed countries and has to be considered in differential diagnosis. The best approach appears to be a combination of skin testing and FNA. Negative results in the identification of M tuberculosis do not exclude the diagnosis of lymph node tuberculosis.

MeSH terms

  • AIDS-Related Opportunistic Infections / diagnosis
  • AIDS-Related Opportunistic Infections / epidemiology*
  • AIDS-Related Opportunistic Infections / pathology
  • Adolescent
  • Adult
  • Aged
  • Antitubercular Agents / therapeutic use
  • Bacteriological Techniques
  • Biopsy, Needle
  • Cross-Sectional Studies
  • Drug Therapy, Combination
  • Female
  • Germany / epidemiology
  • Humans
  • Lymph Nodes / pathology
  • Male
  • Middle Aged
  • Retrospective Studies
  • Tuberculin Test
  • Tuberculosis, Lymph Node / diagnosis
  • Tuberculosis, Lymph Node / drug therapy
  • Tuberculosis, Lymph Node / epidemiology*


  • Antitubercular Agents