Presentation
Cervical lymphadenopathy on clinical examination.
Patient Data
Enlarged necrotic lymph nodes with peripheral enhancement in the right levels II, III, and VA, the largest one extending/involving the sternocleidomastoid muscle. The remainder of the neck and chest are unremarkable.
Case Discussion
This case shows a large group of enlarged right cervical lymph nodes with central necrosis and definitive surrounding inflammatory change. Differentials for this presentation in this age group include infection as the first option, particularly tuberculosis if there is compatible epidemiological support. Other infections such as fungal infection or pyogenic infection are also considerations. Necrotic metastases are a less likely possibility, especially from nasopharyngeal carcinomas.
The lesions were assessed sonographically and FNA was performed.
MYCOBACTERIAL INVESTIGATIONS SPECIMEN: NUCLEIC ACID TESTING (ON SPECIMEN) DNA Amplification Assay for M.tuberculosis Complex(PCR): DETECTED NUCLEIC ACID COMMENT: M.tuberculosis complex DNA DETECTED via this assay. No mutations detected within the selected region of the rpoB gene.
Tuberculous cervical lymphadenitis is also referred to as scrofula.
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