Presentation
Bilateral neck swelling.
Patient Data
multiple bilateral enlarged upper and lower deep cervical lymph nodes showing cystic necrotic centers
multiple enlarged mediastinal lymph nodes in the retrocaval paratracheal, prevascular, aortopulmonary and hilar regions also with necrotic centers
right upper lobar and to less extent right lower lobar apical reticulonodular densities with scattered nodular consolidative patches, mild bronchiectatic changes and hyperlucent areas of air trapping seen in the upper chest
Case Discussion
Biopsy and culture of the cervical lymph nodes were positive for Mycobacterium tuberculosis.
Tuberculous cervical lymphadenitis is the most common manifestation of extrapulmonary tuberculosis and is a frequent cause of peripheral lymphadenitis in the developing world.
CT appearances of tuberculous lymphadenitis are variable, depending on the degree of caseation present in the node. Nodes may initially appear merely enlarged, often with attenuation similar to muscle. Eventually, central caseation develops and the nodes become centrally low density and eventually frankly cystic. They are, usually, matted together with only minor surrounding inflammatory change.
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