What Do My Lab Test Reports Indicate?

Posted on Sun, 30 Oct 2016

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sun, 30 Oct 2016 Answered on

Thu, 17 Nov 2016 Last reviewed on

Question : I am 42. Incidentally, we found some lymp nodes are swollen. So far there was no symptoms.

The swelling was first noticed four years before. but so far no symptoms.

FNAC 28/03/2016 : US Guided Left Anxillary Lymp node

Satisfactory for evaluation

Negative for malignant cells

Smear shows occasional epithelioid granulomas, Langhan's giant cells
polymorphous lmphoid cells in a haemorrhagic background.

Impression : Features are suggestive of granulomatous lymphadentitis possibly of tuberculous origin

MRI on 28/03/2016 : size 1.7 x 2.6 the largest. And FNAC taken on this date

CT on 14/09/2016 : 1.6 x 1.1 and 1.8 x 1.0 ( Noticed reduced in size compared to MRI from 28/3/2016)

I am asked to take Rifampicin 600mg, isoniazid 300mg, Ethumbutaol 1200mg

Still not started any treatment. Want to confirm if the treatment path is ok,

because i have to take tabs for 6 months. I doubt that the reduce in size is due

to FNAC procedure which would have punctured it.

The word "possibly" in FNAC impression created a doubt if the observation is correct.

Answered by Dr. Drkaushal85 (7 hours later)

Brief Answer:
I don't know why pyrazinamide is not given.

Detailed Answer:
Thanks for your question on Healthcare Magic.
I can understand your concern.
No, reduction in size is not due to FNAC procedure.
Reduction is due to anti tubercular drugs you are taking.
Ideally, four drugs, isoniazid, rifampicin, pyrazinamide and ethambutol should be given.
I don't know why pyrazinamide is not given.
Ideally you should take pyrazinamide along with other three drugs.
Pyrazinamide is very good drug for rapid recovery in tuberculosis.
So discuss with your doctor about starting pyrazinamide.
Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Drkaushal85 (40 minutes later)

as mentioned earlier, I have not started any medication so far. my concern is if the TV diagnosis is correct or not.

since I am having this lympnode for past 4 years without any symptoms, why can't I wait for some symptoms to start any treatment.

Answered by Dr. Drkaushal85 (24 hours later)

Brief Answer:
You can wait for 6 months.

Detailed Answer:
Thanks for your follow up question on Healthcare Magic.
I can understand your concern.
Sorry for misunderstanding and for late reply.
You can wait for 6 months and get done repeat imaging to see the size. If size is similar then no need to worry but if size is increasing then start anti tubercular drugs.
Hope I have solved your query. I will be happy to help you further. Sorry for late reply. Wish you good health. Thanks.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar