Tuberculosis Forum - Lump above sternum

Conditions and Diseases > Tuberculosis Forum > Lump above sternum - TB ?

Q: Lump above sternum - TB ?

asked by: DoctorQuestion on September 29th, 2009

I had a visible lump in my neck (centrally) just above sternum. CT revealed multiple enlarged lymphnodes on the right side of neck, pre para and tracheal regions. Larger ones were (about 1.5 to 2 cm) were necrotic and smaller non necrotic nodes were also present. FNAC showed granulomatous leisions. ESR was 45 and Mantoux showed 21 mm induration. Based on these results my doctor said this should be TB (although he saidthe chances that this is TB is 99%, as only if a TB bacteria is seen the the diagnosis can be 100% confirmed). I started on ATD and am in 6th week of treatment.
The nodes have not decreased in size and I have noticed 2 small nodes since last week, about size of pepper on the left side of the neck, where none was present before. I am dead scared that this could be some form of cancer. Can you please tell me if this could be cancer?
I dont have fever or loss of appetite. I am so anxious.

Replies(1)

Dr. Kokil Mathur , MD

replied on September 30th, 2009

Tuberculosis Answer A7403

Hi
Welcome to the forum!
Your signs and symptoms (lymph nodes, granulomatous lesions in nodes, ESR was 45 and Mantoux showed 21 mm induration) are very suggestive of TB. However if you had BCG vaccination as a child then Mantoux will anyways come positive. The only other thing is tat ESR though is high, is not very high as is usually seen in active TB. Also you did not have fever at all, whereas low grade fever is seen in TB.There are other conditions which cause a granulomatous lymph node with increase in ESR are sarcoidosis, Crohn’s disease, histoplasmosis, cat scratch fever, and Cryptococcosis (causes both necrotic and non-necrotic lymph nodes). These conditions should also be looked into as a possible diagnosis especially Cryptococcosis.
However a confirmed diagnosis cannot be made on net. You should consult an internal medicine specialist or an infectious disease specialist regarding this. Hope this helps. Take care!

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