A Case Report of Isolated Inguinal Tuberculous Lymphadenitis.

Koo, Hyun Kook; Kim, Young Seok; Kim, Min Joo; Roh, Tai Suk; Rah, Dong Kwun

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Case Report

Journal of the Korean Society of Plastic and Reconstructive Surgeons 2010;37(5):705-707.
Published online September 1, 2010.

A Case Report of Isolated Inguinal Tuberculous Lymphadenitis.

Hyun Kook Koo, Young Seok Kim, Min Joo Kim, Tai Suk Roh, Dong Kwun Rah

¹Institute for Human Tissue Restoration, Department of Plastic and Reconstructive Surgery, Yonsei University College of Medicine, Seoul, Korea. psyskim@yuhs.ac
²Institute for Human Tissue Restoration, Department of Pathology, Yonsei University College of Medicine, Seoul, Korea.

Abstract

PURPOSE
Tuberculous lymphadenitis constitutes about 30% of all types of extrapulmonary tuberculosis. Cervical lymphadenitis is the commonest form (70%), followed by axillary and inguinal. But inguinal tuberculous lymphadenitis is rare form. Especially isolated inguinal tuberculous lymphadenitis was seldom reported. In Korea, that case was not reported. This case emphasizes the need for awareness of tuberculosis as a possible cause of isolated inguinal adenitis. METHODS: We experienced one case of isolated inguinal tuberculous lymphadenitis. We analyzed clinical features, preoperative assessments and method of treatments.
RESULTS
A 37-year-old female patient presented with a painless swelling in the left inguinal region of 12 month's duration. There was no history of urethral discharge, dysuria, genital sores, unprotected sexual contacts or trauma. Examination revealed enlarged left inguinal lymph nodes, 2 x 1 cm, non-tender and firm mass. The external iliac, popliteal, right inguinal and other groups of lymph nodes were normal. Serologic tests, urinary tests and chest radiologic test were normal. The excision of mass was performed under the general anesthesia. A excisional biopsy showed chronic granulomatous inflammation with caseous necrosis, consistent with tuberculosis. After excision, the primary repair was done and completely healed on postoperative 25 days.
CONCLUSION
The isolated inguinal tuberculous lymphadenitis was rare form of inguinal suppurative mass. Although medical management is the principal mode of therapy of tuberculous adenitis and surgery is rarely necessary, we didn't consider the possibility of tuberculous lymphadenitis in our case. A high index of suspicion is essential for a diagnosis of isolated inguinal tuberculous lymphadenitis. Our case emphasizes this importance and illustrates the need for awareness of tuberculosis as a possible cause of isolated inguinal adenitis.

Keywords: Isolated Inguinal tuberculous lymphadenitis; Inguinal mass; inguinal tuberculosis; Tuberculous lymphadenitis; Extrapulmonary tuberculosis

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