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.

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: Chest, Head & Neck
Tags: cervical, lung
Inclusion in quiz mode: Included

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