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Objectives: The aim of the present study was to identify differences in clinical characteristics between patients with tuberculous cervical lymphadenitis and those with nontuberculous cervical lymphadenitis and to determine the diagnostic accuracy of fine needle aspiration (FNA) cytology. Study Design and Setting: Seventy-two patients with inflammatory cervical lymphadenitis were studied retrospectively. They were divided into 2 groups: group 1 consisted of those with tuberculous lymphadenitis and group 2 consisted of those with non-tuberculous lymphadenitis. The demographic characteristics, clinical parameters, and hematological and cytological results of the 2 groups were compared. Results: Other than there being a significantly higher proportion of foreign-born patients in group 1, there were no differences in clinical characteristics between the 2 groups. The sensitivity and specificity of FNA cytology in the diagnosis of tuberculous lymphadenitis were 88% and 96%, respectively. Conclusion: It is difficult to clinically differentiate tuberculous from nontuberculous lymphadenitis. FNA cytology is useful in the diagnosis of tuberculous lymphadenitis. Significance: In regions where tuberculosis is endemic, treatment can be instituted without the need for excisional biopsy if the FNA results show characteristic caseating granuloma. (Otolaryngol Head Neck Surg 2002;126:176-9.)

Problem: To investigate the efficacy of medical antituberculous treatment in patients with tuberculous cervical lymphadenitis without pulmonary tuberculosis. Methods: We followed 46 patients with tuberculous cervical lymphadenitis who were treated at Dicle University, Diyarbakir, Turkey between 1996 and 2001. Mean age at presentation was 32.2 ± 14.9. Diagnosis was based on clinical findings, results of the PPD tests (Mantoux test) and histopathologic appearance of caseating granuloma, which was consistent with tuberculosis in all cases. The chief complaint was a cervical mass localized mostly to the posterior cervical and/or submandibular regions. Treatment included standard antituberculous medications including isoniasid, rifampisin, and etambutol. Treatment period was between 9 and 12 months with a mean of 7.8 months. During follow-up, excisional biopsy was performed when the lymphadenopathy was bigger than 1 cm in diameter. Results: After clinical and histopathological evaluation, recurrent disease was observed in 8 patients (17 %). Lymphadenopathy was detected in the cervical region (6 patients) mesentery (1 patient) and spleen (1 patient). Cervical excisional biopsy was consistent with tuberculosis in these 6 patients. Conclusion: Patients with tuberculous cervical lymphadenitis should have follow-ups regularly. When there is no cure, the treatment period should be extended to eradicate the disease and other treatment alternatives such as surgery should be kept in mind. Significance: Mycobacterial infections have been shown to be increasing in number worldwide. Standard anti-tuberculous drugs are used for medical treatment. Anti-tuberculous drug resistance is also becoming more frequent. Support: None reported.

Mycobacterial cervical lymphadenitis, or scrofula, may be caused by Mycobacterium tuberculosis, or the atypical mycobacteria. It is important to distinguish between tuberculous cervical lymphadenitis and atypical mycobacterial cervical lymphadenitis, since medical and surgical treatment of each of these entities is different. The two types of scrofula are compared and contrasted. The appropriate treatment of each is discussed, and the complications of improper management are described.