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6 Posts

indidoc1
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Topics: 50
Posts: 978

12/15/07 - 08:22 AM

confused about a kaplan scenario..

32 yr old fem comes wth neck mass fr several wks. Also has fever,weight loss & sweats.. The 1st step in Mx is.....??

My answer is FNAC (Fine needle aspiration) to rule out TB 1st.

Kaplan says - do excisional biopsy fr lymphoma..

But i say that if its TB, we hv just given her a chronic draining sinus by doing excisional biopsy confused

So my answer is FNAC fr TB 1st, followed by excision if its negative.

Any comments plz? raised eyebrow

Edited by indidoc1 on 12/15/07 - 10:58 AM

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drduck
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Topics: 82
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12/15/07 - 08:44 AM

well quite a nice Q.
but not quite convinced with ur answer, u know why...
FNAC not a diagnosic tool for TB.
there are many more NON INVASIVE ways by which we can diagnose TB.

about ur Q, seeif it has to be hodgkin....it has to nothing else......u just cannot go on doing biopsy of every neck mass....sounds crazy

lady, 32 yrs.....it can be goitre, solitary lymphnode enlargement, can be lymphoma.
now if she doesnt have goitre.....i mean if in the Q...it is ruled out that patient doent have thyroid related symptoms.....then one shud think of the other 2,
for that there is no use of FNAC.
u have to do excisional biopsy
i hope u r not missing out some part of the Q.
i think kaplan is correct in saying that biopsy better than FNAC.

anyone there to share some knowledge??

neurom
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Topics: 3
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12/15/07 - 09:23 AM

What kind of TB can cause a neck mass???

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indidoc1
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12/15/07 - 09:23 AM

drduck wrote:
there are many more NON INVASIVE ways by which we can diagnose TB.

for example?

how do we diagnose tuberculous lymph nodes by non-invasive methods?

God!! i m more confused now sticking out tongue

Anyways.. thyroid is ruled out bcoz its in the hemat chapter wink

n we r to assume its a lymph node swelling... coz its done that way in the lect.
Lets say its a lymph node swelling... THEN?? raised eyebrow

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indidoc1
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12/15/07 - 10:02 AM

neurom wrote:
What kind of TB can cause a neck mass???

TB in any of the structures drained.. pulmonary or oropharyngeal.

Or it can be a common form of extra-pulmonary TB affecting only lymph nodes.. called scrofula.

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neurom
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Topics: 3
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12/15/07 - 10:40 AM

thanks, well in this case it is better to rule out lymphoma rather than prevent chronic sunus drainage...

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