Tuberculosis - cervical lymph nodes and lung

Case contributed by Dr Alexandra Stanislavsky

Presentation

30 year old male presents with fevers and an enlarging neck mass.

Modality: CT
Modality: X-ray

Case Discussion

CT of the neck demonstrates a large, centrally necrotic, lobulated mass in the path the lower internal jugular chain on the left, consistent with a matted group of enlarged, necrotic lymph nodes (scrofula).

Review of the lung apices reveals a right upper lobe opacity with central cavitation.

Although subtle, both of these findings are observed on the chest x-ray: increased soft tissue density projected over the left upper chest, and patchy right apical opacities which happen to overlie the 1st rib.

The patient was a resident of a tuberculosis endemic area and TB treatment commenced while cultures are in progress.  Quantiferon assay positive.

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Case Information

rID: 12171
Case created: 27th Oct 2010
Last edited: 17th Sep 2015
Systems: Head & Neck, Chest
Tags: cervical, lung
Inclusion in quiz mode: Included

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