경부 톡소플라즈마 림프절염의 임상적 고찰

Abstract

Background and Objectives Toxoplasmosis is a disease caused by an intracellular parasite,Toxoplasma gondii. There has been only a few studies done on cervical toxoplasma lymphadenitis,and this study was performed to evaluate its clinical characteristics and outcomes. Subjects and Method We retrospectively reviewed the patients diagnosed with cervicaltoxoplasma lymphadenitis from January 2010 to December 2019. We investigated clinicalpathologic findings, treatment and clinical outcomes. Results Enrolled in the study were 21 patients who were confirmed with typical pathologicfindings in an excisional biopsy (16/21) and core needle biopsy (5/21). Nine patients were maleand 12 patients were female, with the mean age of 46.1±13.59 (19-70). All patients complainedof neck masses and 5 (23.8%) patients showed pain or tenderness. Only one (4.8%) patient hadmild fever. Fine needle aspiration cytology was performed in 5 patients, with no resultingpathognomonic outcomes in any one of the patients. CT scan was performed in 15 patients, with8 (53.3%) patients showing multiple nodal enlargements but 7 (46.6%) patients showing a singleenlarged lymph node. The most frequently involved location was level I (53.3%), followedby level II (46.6%), level V (46.6%), level III (40.0%), and level IV (20.0%). The serologic testfor toxoplasma revealed positive IgG (100%) and IgM (85.7%). Treatments were excision only(61.9%) and excision with pharmacologic treatment using sulfonamide or pyrimethamine(38.1%). There was no case of recurrence after treatment. Conclusion Cervical toxoplasma lymphadenitis can be diagnosed by biopsy but needle aspirationhas little role. It shows favorable clinical outcomes after treatment.