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Jung, Lee, Choi, Yoo, Lee, Lim, Shin, Kim, Park, Kim, and Choi: Clinical implication of Dendritic Cell Infiltration in Cervical Tuberculous Lymphadenitis
Original Article
Tuberculosis and Respiratory Diseases

Tuberculosis and Respiratory Diseases 2006; 60(5): 523-531.

Published online: 31 May 2006

DOI: https://doi.org/10.4046/trd.2006.60.5.523

Clinical implication of Dendritic Cell Infiltration in Cervical Tuberculous Lymphadenitis

Jae Woo Jung, M.D., Young Woo Lee, M.D., Jae Cheol Choi, M.D., Seung Min Yoo, M.D.1, Hwa Yeon Lee, M.D.1, Seoung Young Lim, M.D.3, Jong Wook Shin, M.D., Jae Yoel Kim, M.D., In Whn Park, M.D., Mi Kyung Kim, M.D.2, Byoung Whui Choi, M.D.

Department of Internal Medicine, College of Medicine, Chung-Ang University, Seoul, Korea.

1Department of Radiology, College of Medicine, Chung-Ang University, Seoul, Korea.

2Department of Pathology, College of Medicine, Chung-Ang University, Seoul, Korea.

3Department of Internal Medicine, Kangbuk Samsung Hospital, Sung Kyun Kwan University, School of Medicine, Seoul, Korea.

Address for correspondence: Jong Wook Shin, M.D., Address: Chung-Ang University Hospital, Department of Internal Medicine, 21, Heok-Suk Dong, Dongzauk Gu, Seoul, Korea. Phone: 02-6299-1407, Fax: 02-6298-8351, basthma@hanmail.net

Received 14 February 2006       Accepted 3 May 2006

Copyright © 2006 The Korean Academy of Tuberculosis and Respiratory Diseases

Abstract

Background

Cervical tuberculous lymphadenopathy is a very common disease with a similar incidence to pulmonary tuberculosis. Dendritic cells play a role of initial antigen presentation of this illness. Nevertheless, the precise role of these antigen-presenting cells according to the clinical features in unclear. The aim of this study was to determine the clinical implication of dendritic cell infiltration in the cervical lymph nodes.

Methods

A review of the clinical characteristics was carried out retrospectively based on the clinical records and radiography. Immunohistochemical staining was performed on the available histology specimens of 72 cases using the S-100b polyclonal antibody for dendritic cells. The number of dendritic cells with tuberculous granuloma were determined. A X2 test, unpaired T test and multiple logistic regression analysis were performed.

Results

Thirty percent of subjects had previous or concurrent pulmonary TB. Twenty one percent of cases showed a positive reaction on the AFB stain. Within a granuloma, the number of infiltrated dendritic cells was 113.0±7.0. The incidence of fever and cough decreased with increasing infiltration of dendritic cells Multivariate regression analysis showed that the infiltration of dendritic cells could significantly contribute to fever.

Conclusion

Overall, dendritic cells can control a Mycobacterium tuberculosis infection and modulate the immune response, as well as resolve the clinical manifestations of TB lymphadenopathy.

Keywords: Tuberculosis, Lymph Node, S-100b, Dendritic Cells

Figures and Tables

Figure 1
Hypothetical scheme for tuberculosis in the lungs and lymph node.
M. tuberculosis, Mycobacterium tuberculosis; DC, dendritic cells; MHC, major histocompatibility complex
In pulmonary tuberculosis, dendritic cells have role of initial antigen presentation.
trd-60-523-g001
Figure 2
Immunohistochemical stain.
trd-60-523-g002
Table 1
Clinical characteristics of study subjects
trd-60-523-i001

TB, tuberculosis; LAP, lymphadenopathy

Median age is 29 years old and 30% of subjects had previous or concurrent pulmonary TB.

Table 2
Clinical and histologic characteristics of study subjects
trd-60-523-i002

AFB, acid fast bacilli; DCs, dendritic cells

21% of cases showed positive reaction on AFB stain. Within a granuloma, numbers of infiltrated dendritic cells was 113.0±7.0.

Table 3
Comparison of clinical & microscopic characteristics between abscess positive and abscess negative group
trd-60-523-i003

AFB, acid fast bacilli; DCs, dendritic cells; NS, statistically not significant

The presence of abscess is related to presence of pain. (P value : 0.015)

Table 4
Comparison of clinical & microscopic characteristics between fever positive and fever negative group
trd-60-523-i004

AFB, acid fast bacilli; DCs, dendritic cells; NS, statistically not significant As infiltration of dendritic cells increased, incidence of fever decreased.

Table 5
Comparison of dendritic cells infiltration in cervical lymphadenopathy according to clinical manifestation
trd-60-523-i005

DCs, dendritic cells; AFB, acid fast bacilli; CXR, chest X ray; TB, tuberculosis; NS, statistically not significant

As infiltration of dendritic cells increased, incidence of fever and cough decreased.

Table 6
Contributing factors to develop fever
trd-60-523-i006

CI, confidence interval

According to multivariate regression analysis, infiltration of dendritic cells could significantly contribute to fever.

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