{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T00:03:38Z","timestamp":1756339418124,"version":"3.44.0"},"reference-count":11,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2023,3,16]]},"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:p>We present a case of massive generalised necrotic lymphadenopathy due to tuberculosis (TB) without any solid organ involvement. An immunocompetent man in his early 30s presented 1\u2009year ago with weight loss, cough and a solitary cervical node. Contrast-enhanced CT scan thorax showed massive enlargement of almost all groups of mediastinal nodes with large areas of necrosis. Ultrasound examination revealed multiple necrotic abdominal nodes. Core biopsy of the supraclavicular node confirmed TB by histopathology and molecular testing. His Mantoux test was negative suggesting tuberculin anergy. Biopsy of deep nodes was avoided. He responded well to standard antitubercular treatment in weight-corrected doses along with systemic steroids which were prescribed to prevent further breakdown\/rupture of nodes. After the extended TB treatment for 12 months, he is asymptomatic and has gained weight, with complete resolution of cervical node and near complete resolution of all deep nodes.<\/jats:p>","DOI":"10.1136\/bcr-2022-252558","type":"journal-article","created":{"date-parts":[[2023,3,21]],"date-time":"2023-03-21T10:22:09Z","timestamp":1679394129000},"page":"e252558","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Massive generalised lymphadenopathy: a rare presentation of tuberculosis with a favourable outcome"],"prefix":"10.1136","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4218-0455","authenticated-orcid":false,"given":"Tushar Ramesh","family":"Sahasrabudhe","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Dr D Y Patil Medical College, Hospital and Research center, Dr D Y Patil Vidyapeeth, Pimpri, Pune (Deemed University), Pune, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kurinji Ramachandran","family":"Senthamizh","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Dr D Y Patil Medical College, Hospital and Research center, Dr D Y Patil Vidyapeeth, Pimpri, Pune (Deemed University), Pune, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shailesh Bhanudas","family":"Meshram","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Dr D Y Patil Medical College, Hospital and Research center, Dr D Y Patil Vidyapeeth, Pimpri, Pune (Deemed University), Pune, Maharashtra, India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2023,3,21]]},"reference":[{"key":"2025082702464130000_16.3.e252558.1","first-page":"50","article-title":"Difficulties in managing lymph node tuberculosis","volume":"21","author":"Gupta","year":"2004","journal-title":"Lung India"},{"key":"2025082702464130000_16.3.e252558.2","doi-asserted-by":"crossref","unstructured":"Saul Suster MD , Cesar A , Moran MD . Diagnostic pathology: thoracic. 2017: 510\u20133. Available: https:\/\/www.sciencedirect.com\/science\/article\/pii\/B9780323377157501079","DOI":"10.1016\/B978-0-323-37715-7.50107-9"},{"key":"2025082702464130000_16.3.e252558.3","doi-asserted-by":"crossref","unstructured":"Edythe Albano MD . Generalised lymphadenopathy. In: Berman\u2019s pediatric decision making. 2011: 22\u20133. Available: https:\/\/www.sciencedirect.com\/science\/article\/pii\/B9780323054058000140","DOI":"10.1016\/B978-0-323-05405-8.00014-0"},{"key":"2025082702464130000_16.3.e252558.4","first-page":"590","article-title":"The profile of lymphadenopathy in adults and children","volume":"60","author":"Darnal","year":"2005","journal-title":"Med J Malaysia"},{"key":"2025082702464130000_16.3.e252558.5","doi-asserted-by":"crossref","DOI":"10.1136\/bmj.4.5735.573","article-title":"Tuberculin anergy","volume":"4","year":"1970","journal-title":"Br Med J"},{"key":"2025082702464130000_16.3.e252558.6","doi-asserted-by":"crossref","DOI":"10.5001\/omj.2020.62","article-title":"Tuberculous adenitis with concurrent Hodgkin lymphoma: a case report","volume":"35","author":"Khan","year":"2020","journal-title":"Oman Med J"},{"key":"2025082702464130000_16.3.e252558.7","unstructured":"Bansiwal B , Maneesha J , Ramesh Chand M , et al . Adjunctive effects of oral steroids with anti-tuberculosis drugs in cervical lymphadenopathy. Southwest Journal of Pulmonary, Critical Care and Sleep 2021. Available: https:\/\/www.swjpcc.com\/pulmonary\/2021\/1\/10\/adjunctive-effects-of-oral-steroids-along-with-anti-tubercul.html#"},{"key":"2025082702464130000_16.3.e252558.8","unstructured":"World Health Organization . Index TB guidelines. Guidelines on extra-pulmonary tuberculosis for India. 2016. Available: https:\/\/tbcindia.gov.in\/showfile.php?lid=3245"},{"key":"2025082702464130000_16.3.e252558.9","doi-asserted-by":"crossref","first-page":"881","DOI":"10.1080\/17476348.2018.1515628","article-title":"Corticosteroids as an adjunct to tuberculosis therapy","volume":"12","author":"Schutz","year":"2018","journal-title":"Expert Rev Respir Med"},{"key":"2025082702464130000_16.3.e252558.10","doi-asserted-by":"crossref","first-page":"4","DOI":"10.29245\/2689-9981\/2018\/2.1115","article-title":"Role of add-on prednisolone in the management of peripheral lymph node tuberculosis","volume":"1","author":"Gupta","year":"2018","journal-title":"J Infectiology"},{"key":"2025082702464130000_16.3.e252558.11","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1177\/0049475520984745","article-title":"Outcome of lymph node tuberculosis management with conventional treatment with and without prednisolone","volume":"51","author":"Sharmin","year":"2021","journal-title":"Trop Doct"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2022-252558","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T09:46:49Z","timestamp":1756288009000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2022-252558"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3]]},"references-count":11,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2023,3,21]]},"published-print":{"date-parts":[[2023,3]]}},"alternative-id":["10.1136\/bcr-2022-252558"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2022-252558","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2023,3]]}}}