Isolated inguinal tuberculous lymphadenitis

Isolated inguinal tuberculous lymphadenitis (TL) with no other pulmonary or extrapulmonary involvement is rare. A 74-year-old male patient presented with inguinal lymph node swelling at a primary care clinic. On palpation, the lymph node was polymorphic and soft in consistency, and ultrasonography revealed a hypoechoic node with the absence of the hilum and an intra-nodal strong echo. Referring to a tertiary care hospital, a computed tomography scan revealed multinodular inguinal lymph node without any active inflammatory lesions in the lung. The T-SPOT.TB assay was positive. An excisional biopsy of the lymph node revealed caseous necrosis on histopathological examination, and the patient was diagnosed with TL. Isolated inguinal lymphadenopathy, even in the absence of pulmonary involvement, necessitates consideration of TL in the diagnostic process.