Diagnostic problems of tuberculous cervical adenitis (scrofula)

Area of Science:

• Infectious Diseases
• Pulmonology
• Otolaryngology

Background:

• Tuberculosis (TB) can present as a cervical mass, often mimicking other conditions.
• Accurate and timely diagnosis of tuberculous cervical adenitis is crucial for effective management.
• Physician awareness of TB as a cause of cervical masses needs enhancement.

Purpose of the Study:

• To review diagnostic procedures for tuberculous cervical adenitis.
• To propose a simplified diagnostic protocol for suspected cases.
• To increase physician awareness of tuberculosis as a potential cause of cervical masses.

Main Methods:

• Retrospective study of 57 patients with tuberculous cervical adenitis.
• Review of diagnostic procedures including chest x-ray, tuberculin test, fine-needle aspiration (FNA), microbiology culture, and histopathology.
• Data collected from North West Armed Forces Hospital, Tabuk, Saudi Arabia (March 1989 - April 1993).

Main Results:

• Chest x-ray showed abnormalities in 14% of patients.
• Tuberculin test was positive in 92% of cases.
• Mycobacterium tuberculosis was cultured from 50% of specimens; histopathology was suggestive of TB in all cases.

Conclusions:

• A combination of thorough history, physical examination, tuberculin test, and FNA facilitates early diagnosis.
• Early treatment can commence before definitive diagnosis via incisional biopsy and culture.
• Tuberculosis must be considered in the differential diagnosis of neck masses.