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Cervical tuberculous adenitis: CT manifestations.

D L Reede, R T Bergeron

    Radiology
    |March 1, 1985
    PubMed
    Summary

    Cervical tuberculous adenitis is an emerging diagnosis in the US, particularly in young adults from Southeast Asia. Characteristic CT findings, like conglomerate nodal masses, aid in diagnosing this condition, even with atypical presentations.

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    Area of Science:

    • Infectious Diseases
    • Radiology
    • Oncology

    Background:

    • Cervical tuberculous adenitis is increasingly diagnosed in the United States.
    • It presents as an asymptomatic neck mass, often in young adult immigrants from Southeast Asia.
    • Traditional diagnostic indicators like tuberculosis history or abnormal chest X-rays are not always present.

    Purpose of the Study:

    • To highlight the diagnostic utility of computed tomography (CT) in identifying cervical tuberculous adenitis.
    • To describe specific CT patterns suggestive of tuberculous adenitis that may mimic other conditions.
    • To emphasize the importance of considering tuberculous adenitis in the differential diagnosis of neck masses.

    Main Methods:

    • Review of clinical presentations and CT findings in patients diagnosed with cervical tuberculous adenitis.
    • Analysis of CT imaging characteristics, including nodal morphology, enhancement patterns, and surrounding tissue involvement.
    • Correlation of CT findings with clinical history, purified protein derivative (PPD) test results, and tuberculosis skin tests.

    Main Results:

    • CT can reveal various nodal disease patterns in tuberculous adenitis, some mimicking benign or neoplastic conditions.
    • A multiloculated or multichambered nodal mass with central lucency and thick rims of enhancement is highly suggestive.
    • Minimally effaced fascial planes in conjunction with these findings further support the diagnosis.
    • Positive tuberculosis skin tests are common, though anergy can occur.

    Conclusions:

    • CT imaging plays a crucial role in diagnosing cervical tuberculous adenitis, especially when clinical signs are ambiguous.
    • Specific CT features, such as conglomerate nodal masses with characteristic enhancement, are key diagnostic indicators.
    • Cervical tuberculous adenitis should be considered in the differential diagnosis of asymptomatic neck masses, particularly in at-risk populations.

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