Brief Answer:
Please do advanced tests of TB and lymph node FNAC

Detailed Answer:
Hi XXXX,
Thanks for writing in to us.

I have read through your query in detail.
The presence of lymph nodes in neck is commonly due to infection in the head and neck region, tuberculosis and rarely can be seen associated with cancer.

In XXXXXXX tuberculosis is one of the commonest diseases so any neck lymph nodes should be evaluated in detail. Since tuberculosis can affect any part of the body from head to toe, your doctor is doing a complete general examination with required investigations.

TB treatment must only be started after confirming diagnosis.

Tuberculosis generally causes symptoms like unexplained weight loss and fever for 2 months and associated cough. At times tuberculosis can also present as a silent disease with not many symptoms including absence of cough. There is cough in about 40 to 60 percent of tuberculosis patients. In patients having tuberculosis of other organs, only 20 percent have cough and abnormal chest X ray findings.

I have gone through your ultrasound neck and find that there is no mention about size of the lymph nodes. There for I consider that the lymph nodes are not too many in number and also small in size. In this situation, the findings in neck lymph nodes are not confirmatory of TB. Small nodule in left lobe of thyroid is not significant.

The X ray chest was required and it is normal so there is no lung problems.

The ultrasound abdomen is also normal and not showing any problems except fatty liver.

In your blood reports, I find that hemoglobin is at lower limits of normal and ESR is mildly elevated.

The scrotum ultrasound report shows old funiculitis which is inflammation of spermatic cord on the right side. Apart from this there are small lymph nodes in the right groin and this is most likely due to the funiculitis.

There is a mention of a surgery on right side, details of which are not mentioned.

The Mantoux test is 30 mm but this is not always reliable and many patients can have false positive.

After having gone through the complete reports made available to me, I feel there is a need to first get advanced tests for TB like gold or platinum test to know if there are any TB antibodies in you.

The single confirmatory test which can reliable give proof of you having TB is a lymph node FNAC or biopsy. This will show inflammatory cells present in the lymphnodes should you have TB.

Hope this answers your question. Please feel free to correct any oversight in my interpretation of your problems and discuss them in detail as per your requirements.

Hope your query is answered.
Do write back if you have any doubts.

Regards,
Dr.Vivek

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