Tuberculous Lymphadenitis in Abdominal and Pelvic Lymph Nodes

Tuberculous lymphadenitis presents with painless enlargement commonly in cervical and to a lesser degree in supraclavicular and axillary lymph nodes. Patients are usually asymptomatic and the disease is diagnosed during physical examination or radiological imaging performed for another reason. Sixty-years old woman presenting with urinary incontinance and vaginal cuff prolapsus was operated. Intraoperatively, multiple conglomerated lymphadenopathies were observed in abdominal and pelvic region. Examination of biopsy specimens obtained from these lymph nodes revealed tuberculous lymphadenitis. When the patient was questioned again, it was learned that she had obscure abdominal pain and anorexia previously. PPD test revealed an induration of 50x35 mm. After two months of antituberculous therapy, a slight regression was observed in the size of lymph nodes at abdominal CT. Altough this case was diagnosed coincidentally, it shows that abdominal tuberculous lymphadenitis must also be kept in mind in differential diagnosis, in patients presenting with obscure abdominal symptoms or in whom imaging techniques revealed enlargment of abdominal lymph nodes.