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Tuberculous Lymph Nodes
Nicholas A. Koontz, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Abbreviations

                • Tuberculous (TB) lymph nodes
              • Synonyms

                • Cervical TB adenitis
                • Cervical TB lymphadenitis
                • TB scrofula
              • Definitions

                • Adenopathy due to Mycobacterium tuberculosis infection

              IMAGING

              • General Features

                • Imaging Recommendations

                  • Radiographic Findings

                    • CT Findings

                      • MR Findings

                        • Ultrasonographic Findings

                          • Nuclear Medicine Findings

                            DIFFERENTIAL DIAGNOSIS

                              PATHOLOGY

                              • General Features

                                • Gross Pathologic & Surgical Features

                                  • Microscopic Features

                                    CLINICAL ISSUES

                                    • Presentation

                                      • Demographics

                                        • Natural History & Prognosis

                                          • Treatment

                                            DIAGNOSTIC CHECKLIST

                                            • Consider

                                              • Image Interpretation Pearls

                                                Selected References

                                                1. Gehrke T et al: Tuberculosis in the head and neck: changing trends and age-related patterns. Laryngoscope. ePub, 2021
                                                2. Seo YJ et al: Causes of necrotic features in fine-needle aspirates from cervical lymph nodes. J Pathol Transl Med. 55(1):60-7, 2021
                                                3. Hashmi AA et al: Utility of fine needle aspiration cytology in the evaluation of lymphadenopathy. Cureus. 12(12):e11990, 2020
                                                4. Raja R et al: GeneXpert assay - a cutting-edge tool for rapid tissue diagnosis of tuberculous lymphadenitis. J Clin Tuberc Other Mycobact Dis. 21:100204, 2020
                                                5. Qian X et al: Head and neck tuberculosis: literature review and meta-analysis. Tuberculosis (Edinb). 116S:S78-88, 2019
                                                6. Białek EJ et al: Mistakes in ultrasound diagnosis of superficial lymph nodes. J Ultrason. 17(68):59-65, 2017
                                                7. Liu Q et al: Performance of interferon-γ release assay in the diagnosis of tuberculous lymphadenitis: a meta-analysis. PeerJ. 5:e3136, 2017
                                                8. Azghay M et al: Utility of QuantiFERON-TB Gold In-Tube assay in adult, pulmonary and extrapulmonary, active tuberculosis diagnosis. Int J Infect Dis. 44:25-30, 2016
                                                9. Oishi M et al: Clinical study of extrapulmonary head and neck tuberculosis: a single-institute 10-year experience. Int Arch Otorhinolaryngol. 20(1):30-3, 2016
                                                10. Omura S et al: A clinical review of 38 cases of cervical tuberculous lymphadenitis in Japan - the role of neck dissection. Auris Nasus Larynx. 43(6):672-6, 2016
                                                11. Eisenmenger LB et al: Imaging of head and neck lymph nodes. Radiol Clin North Am. 53(1):115-32, 2015
                                                12. Namale PE et al: Paradoxical TB-IRIS in HIV-infected adults: a systematic review and meta-analysis. Future Microbiol. 10(6):1077-99, 2015
                                                13. Baek HJ et al: Diagnostic accuracy of the clinical and CT findings for differentiating Kikuchi's disease and tuberculous lymphadenitis presenting with cervical lymphadenopathy. Jpn J Radiol. 32(11):637-43, 2014
                                                14. Vorster M et al: Advances in imaging of tuberculosis: the role of ¹⁸F-FDG PET and PET/CT. Curr Opin Pulm Med. 20(3):287-93, 2014
                                                15. Iguchi H et al: Clinical analysis of 21 cases of cervical tuberculous lymphadenitis without active pulmonary lesion. Acta Otolaryngol. 133(9):977-83, 2013
                                                16. Sathekge M et al: FDG-PET imaging in HIV infection and tuberculosis. Semin Nucl Med. 43(5):349-66, 2013
                                                17. Sathekge M et al: Tuberculous lymphadenitis: FDG PET and CT findings in responsive and nonresponsive disease. Eur J Nucl Med Mol Imaging. 39(7):1184-90, 2012
                                                18. Sathekge M et al: Use of 18F-FDG PET to predict response to first-line tuberculostatics in HIV-associated tuberculosis. J Nucl Med. 52(6):880-5, 2011
                                                19. Choi EC et al: Case report. Tuberculous cervical lymphadenitis mimicking metastatic lymph nodes from papillary thyroid carcinoma. Br J Radiol. 82(982):e208-11, 2009
                                                20. Papadopouli E et al: Cervical lymphadenopathy in childhood epidemiology and management. Pediatr Hematol Oncol. 26(6):454-60, 2009
                                                21. Wang WC et al: Tuberculosis of the head and neck: a review of 20 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 107(3):381-6, 2009
                                                22. Archontaki M et al: Intraparotid lymph node tuberculosis. B-ENT. 4(1):35-7, 2008
                                                23. Roberts DS et al: Cervical tuberculosis: a decision tree for protecting healthcare workers. Laryngoscope. 118(8):1345-9, 2008
                                                24. Barnett K et al: Scrofula as a presentation of tuberculosis and HIV. CJEM. 2007 May;9(3):176-9. Erratum in: CJEM. 9(4):303, 2007
                                                25. Menon K et al: A clinical review of 128 cases of head and neck tuberculosis presenting over a 10-year period in Bradford, UK. J Laryngol Otol. 121(4):362-8, 2007
                                                26. Song JY et al: Disease spectrum of cervical lymphadenitis: analysis based on ultrasound-guided core-needle gun biopsy. J Infect. 55(4):310-6, 2007
                                                27. Baskota DK et al: Distribution of lymph nodes in the neck in cases of tuberculous cervical lymphadenitis. Acta Otolaryngol. 124(9):1095-8, 2004
                                                28. Moon WK et al: CT and MR imaging of head and neck tuberculosis. Radiographics. 17(2):391-402, 1997
                                                29. Centers for Disease Control and Prevention: Tuberculosis (TB)
                                                30. Centers for Disease Control and Prevention: Global Health, Tuberculosis
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Abbreviations

                                                              • Tuberculous (TB) lymph nodes
                                                            • Synonyms

                                                              • Cervical TB adenitis
                                                              • Cervical TB lymphadenitis
                                                              • TB scrofula
                                                            • Definitions

                                                              • Adenopathy due to Mycobacterium tuberculosis infection

                                                            IMAGING

                                                            • General Features

                                                              • Imaging Recommendations

                                                                • Radiographic Findings

                                                                  • CT Findings

                                                                    • MR Findings

                                                                      • Ultrasonographic Findings

                                                                        • Nuclear Medicine Findings

                                                                          DIFFERENTIAL DIAGNOSIS

                                                                            PATHOLOGY

                                                                            • General Features

                                                                              • Gross Pathologic & Surgical Features

                                                                                • Microscopic Features

                                                                                  CLINICAL ISSUES

                                                                                  • Presentation

                                                                                    • Demographics

                                                                                      • Natural History & Prognosis

                                                                                        • Treatment

                                                                                          DIAGNOSTIC CHECKLIST

                                                                                          • Consider

                                                                                            • Image Interpretation Pearls

                                                                                              Selected References

                                                                                              1. Gehrke T et al: Tuberculosis in the head and neck: changing trends and age-related patterns. Laryngoscope. ePub, 2021
                                                                                              2. Seo YJ et al: Causes of necrotic features in fine-needle aspirates from cervical lymph nodes. J Pathol Transl Med. 55(1):60-7, 2021
                                                                                              3. Hashmi AA et al: Utility of fine needle aspiration cytology in the evaluation of lymphadenopathy. Cureus. 12(12):e11990, 2020
                                                                                              4. Raja R et al: GeneXpert assay - a cutting-edge tool for rapid tissue diagnosis of tuberculous lymphadenitis. J Clin Tuberc Other Mycobact Dis. 21:100204, 2020
                                                                                              5. Qian X et al: Head and neck tuberculosis: literature review and meta-analysis. Tuberculosis (Edinb). 116S:S78-88, 2019
                                                                                              6. Białek EJ et al: Mistakes in ultrasound diagnosis of superficial lymph nodes. J Ultrason. 17(68):59-65, 2017
                                                                                              7. Liu Q et al: Performance of interferon-γ release assay in the diagnosis of tuberculous lymphadenitis: a meta-analysis. PeerJ. 5:e3136, 2017
                                                                                              8. Azghay M et al: Utility of QuantiFERON-TB Gold In-Tube assay in adult, pulmonary and extrapulmonary, active tuberculosis diagnosis. Int J Infect Dis. 44:25-30, 2016
                                                                                              9. Oishi M et al: Clinical study of extrapulmonary head and neck tuberculosis: a single-institute 10-year experience. Int Arch Otorhinolaryngol. 20(1):30-3, 2016
                                                                                              10. Omura S et al: A clinical review of 38 cases of cervical tuberculous lymphadenitis in Japan - the role of neck dissection. Auris Nasus Larynx. 43(6):672-6, 2016
                                                                                              11. Eisenmenger LB et al: Imaging of head and neck lymph nodes. Radiol Clin North Am. 53(1):115-32, 2015
                                                                                              12. Namale PE et al: Paradoxical TB-IRIS in HIV-infected adults: a systematic review and meta-analysis. Future Microbiol. 10(6):1077-99, 2015
                                                                                              13. Baek HJ et al: Diagnostic accuracy of the clinical and CT findings for differentiating Kikuchi's disease and tuberculous lymphadenitis presenting with cervical lymphadenopathy. Jpn J Radiol. 32(11):637-43, 2014
                                                                                              14. Vorster M et al: Advances in imaging of tuberculosis: the role of ¹⁸F-FDG PET and PET/CT. Curr Opin Pulm Med. 20(3):287-93, 2014
                                                                                              15. Iguchi H et al: Clinical analysis of 21 cases of cervical tuberculous lymphadenitis without active pulmonary lesion. Acta Otolaryngol. 133(9):977-83, 2013
                                                                                              16. Sathekge M et al: FDG-PET imaging in HIV infection and tuberculosis. Semin Nucl Med. 43(5):349-66, 2013
                                                                                              17. Sathekge M et al: Tuberculous lymphadenitis: FDG PET and CT findings in responsive and nonresponsive disease. Eur J Nucl Med Mol Imaging. 39(7):1184-90, 2012
                                                                                              18. Sathekge M et al: Use of 18F-FDG PET to predict response to first-line tuberculostatics in HIV-associated tuberculosis. J Nucl Med. 52(6):880-5, 2011
                                                                                              19. Choi EC et al: Case report. Tuberculous cervical lymphadenitis mimicking metastatic lymph nodes from papillary thyroid carcinoma. Br J Radiol. 82(982):e208-11, 2009
                                                                                              20. Papadopouli E et al: Cervical lymphadenopathy in childhood epidemiology and management. Pediatr Hematol Oncol. 26(6):454-60, 2009
                                                                                              21. Wang WC et al: Tuberculosis of the head and neck: a review of 20 cases. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 107(3):381-6, 2009
                                                                                              22. Archontaki M et al: Intraparotid lymph node tuberculosis. B-ENT. 4(1):35-7, 2008
                                                                                              23. Roberts DS et al: Cervical tuberculosis: a decision tree for protecting healthcare workers. Laryngoscope. 118(8):1345-9, 2008
                                                                                              24. Barnett K et al: Scrofula as a presentation of tuberculosis and HIV. CJEM. 2007 May;9(3):176-9. Erratum in: CJEM. 9(4):303, 2007
                                                                                              25. Menon K et al: A clinical review of 128 cases of head and neck tuberculosis presenting over a 10-year period in Bradford, UK. J Laryngol Otol. 121(4):362-8, 2007
                                                                                              26. Song JY et al: Disease spectrum of cervical lymphadenitis: analysis based on ultrasound-guided core-needle gun biopsy. J Infect. 55(4):310-6, 2007
                                                                                              27. Baskota DK et al: Distribution of lymph nodes in the neck in cases of tuberculous cervical lymphadenitis. Acta Otolaryngol. 124(9):1095-8, 2004
                                                                                              28. Moon WK et al: CT and MR imaging of head and neck tuberculosis. Radiographics. 17(2):391-402, 1997
                                                                                              29. Centers for Disease Control and Prevention: Tuberculosis (TB)
                                                                                              30. Centers for Disease Control and Prevention: Global Health, Tuberculosis