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Lymphadenitis is the most generic form of extra pulmonary manifestation of tuberculosis. It is both diagnostic and therapeutic challenge because it mimics various other pathologic processes and yields inconsistent physical laboratory findings. Diagnosis is quite difficult often requiring biopsy. It is also important to differentiate tuberculous from non-tuberculous mycobacterial cervical lymphadenitis as their treatment protocols are different. We are presenting a case report of two patients who presented with neck swelling. Elastography is a recent advance in the field of sonography helping in identifying nature of pathology. Sonography, doppler and elastographic findings are discussed.

Background: Tuberculous cervical lymphadenitis is commonly encountered in clinical practice. Fine Needle Aspiration Cytology (FNAC) being a simple out-patient diagnostic procedure is well accepted by patients and has practically no complications. Methods: The present study involved 80 patients of cervical lymphadenopathy, who attended the pathology department of the L N medical college and JK hospital, Bhopal from June 2013 to May 2014. After a detailed history and clinical examination, fine needle aspiration cytology of involved nodes was performed in all these patients. Results: Out of 80 cases 32 (40%) cases were of tubercular lymphadenitis, 24 (30%) cases were of reactive hyperplasia of lymph node, 12 (15%) cases were of metastatic deposit of squamous cell carcinoma of lymph node, 10 (12.5)cases were of non-specific lymphadenitis, one case (1.25) was of acute on chronic lymphadenitis and one (1.25) case was of non-Hodgkin’s lymphoma, so out of 80 cases maximum number of cases (32) were of tuberculous lymph node. Conclusion: FNAC has emerged as a first-line diagnostic technique in tuberculosis lymph node. In cervical lymphadenopathy tuberculosis remains a common cause.