Tuberculous cervical lymphadenitis

Case contributed by Dr Itziar Oronoz Mitxelena

Presentation

Caucasian with one month left parotid enlargement, with no improvement after one week of antibiotics and anti-inflammatories. No fever or other associated symptoms.

Patient Data

Age: 25 years
Gender: Male

Ill-defined nodules in the apical segments of the upper lobes, especially the left, some cavitating.

Multiple enlarged left parotid, level II and level V lymph nodes, with central fluid attenuation.

Case Discussion

CT findings in pulmonary TB and tuberculous lymphadenitis have been well described.

Cavitating lung nodules. The left cervical and parotid lymph nodes have central low attenuation, corresponding to areas of caseating necrosis, with peripheral rim enhancement.

In this case, the CT was suspicious for granulomatous disease, most likely tuberculosis. The fine-needle aspiration of an intraparotid lymph node was positive for Mycobacterium tuberculosis.

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