결핵성 경부 림프절염에서 실험실 진단방법의 유용성 및 CT소견과의 연관성

Background and Objectives: Because of the low detection rate of acid-bacilli in specimens, the confirmative diagnosis of tuberculous cervical lymphadenitis is very difficult. Therefore, many kinds of indirect diagnostic methods have been introduced recently. In this study we intended to evaluate the diagnostic efficacy of laboratory tests and their relationship with CT findings. Materials and Methods: We reviewed the medical records of 130 patients who were suspicious with tuberculous cervical lymphadenitis based on history, physical examination, and CT findings from January 2001 to June 2009. The positive rate of each laboratory test was investigated and its relationship with CT findings was evaluated. Results: In 110 cases which were diagnosed as tuberculous cervical lymphadenitis, the positive cases were 8/47 (17%) in PCR, 7/74 (9%) in smear, 4/68 (6%) in cytology, and 103/103 (100%) in histopathology. In terms of their relationship with CT findings which were classified into four types, the positive rate was higher in type III and IV rather than type I and II. Conclusions: To enhance the diagnostic efficacy of laboratory tests, thorough revision on the technique for sample collection and process was demanded. CT findings showing type I and II require more precaution in diagnosis and more advanced diagnostic method hereafter. (J Clinical Otolaryngol 2010;21:56–60)